Table 1 Efficacy of environmental, behavioral and non-pharmacological strategies on pain reactivity in newborn.
From: Non-pharmacological intervention for neonatal pain control
Behavioral, cognitive and contextual interventions | Level of evidence | Grade of Recommendation | ||
|---|---|---|---|---|
Heel Prick | Venipuncture | Other | ||
Non-nutritive sucking (NNS): placing a pacifier or non-lactating nipple in an infant’s mouth to promote sucking behavior with no breast or formula milk to provide nourishment. | 1 | 1 | - | Strong |
Facilitated tucking: holding the arms and legs in a flexed position | 1 | 1 | 3 ET Suctioning | Strong |
Swaddling: wrapping securely the neonate in a sheet/blanket | 1 | 1 | - | Strong |
Positioning: laying the neonate supine | 3 | 3 | - | Weak |
Maternal touching and holding: cradling the baby in the mother’s arms | 3 | 3 | - | Weak |
Environmental care: controlling/ reducing light and noise, clustering care etc. | 3 | 3 | - | Weak |
Individualized developmental care e.g. limiting environmental stimuli, lateral positioning, using supportive bedding, monitoring behavioural clues, respecting circadian rhythms | - | - | 3 ROP screening | Weak |
Skin to skin or Kangaroo Mother Care an infants is placed on their care-giver’s bare chest during a painful procedure or for soothing after a painful procedure | 1 | 2 | 2 IM | Strong |
Sensorial saturation: multiple sensorial stimulation at gustatory, auditory, olfactory and tactile level | 1 | - | - | Strong |
Music therapy: music with intrauterine sounds or instrumental music in association with NNS | 3 | 3 | - | Weak |
Sucrose 24%: in dose of 0.1-0.3 ml orally 2 minutes before the procedure in preterm infants and 1-2 ml in term infants. | 1 | 1 | - | Strong |
Breastfeeding or expressed human milk | 1 | 1 | - | Strong |
Glucose solutions 20-30% in dose of 1-2ml orally 2 minutes before the procedure. | 1 | 1 | - | Strong |