title: Non-nutritive sucking relieves pain for preterm infants during heel stick procedures in Taiwan.
abstract: OBJECTIVE
  This study examined the effectiveness of non-nutritive sucking on preterm infant pain, changes in infant behaviour and frequency of abnormal physiological signals during heel stick procedures in Taiwan.
  
  
  BACKGROUND
  Preterm infants' repetitive exposure to painful procedures may result in changes to brain organisation. Pain management should be a priority in neonatal care.
  
  
  METHODS
  Randomised control trial.
  
  
  METHODS
  Preterm infants (gestational age 28.9-37 weeks) were randomised to two groups: those receiving (experimental, n = 52) or not receiving non-nutritive sucking (control, n = 52) during heel stick procedures. Pain was measured before (for three minutes), during and after (during 10-minute recovery) heel stick procedures by the Premature Infant Pain Profile, changes in infant behaviour and abnormal physiological parameters. Results.  Infants in both groups had similar odds ratios for pain and moderate-to-severe pain (0.57 and 0.58, respectively), after adjusting for time effects, postconceptional age, heel stick duration, painful experiences and baseline Premature Infant Pain Profile score. The pain scores of infants with non-nutritive sucking were significantly lower than those of non-nutritive sucking infants at all eight phases of the heel stick procedures. Infants undergoing heel stick procedures in the experimental group had lower rates ratios for 'grimace' and 'hand to mouth or face' behaviours than control infants (0.73 and 0.78, respectively).
  
  
  CONCLUSIONS
  Non-nutritive sucking effectively reduced pain, particularly mild to moderate pain and behavioural responses to pain in infants receiving heel stick procedures, suggesting that nurses can offer this intervention to relieve pain in preterm infants undergoing invasive procedures.
  
  
  CONCLUSIONS
  Infants should be given an appropriate-sized pacifier for comfort during painful procedures. Nurses need to be informed about the effectiveness of non-nutritive sucking, its analgesic mechanisms and how to use and incorporate it into practice.
authors.affiliation: School of Nursing, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Jen-Jiuan
authors.initials: JJ
authors.lastname: Liaw
authors.forename: Luke
authors.initials: L
authors.lastname: Yang
authors.forename: Yin
authors.initials: Y
authors.lastname: Ti
authors.forename: Susan Tucker
authors.initials: ST
authors.lastname: Blackburn
authors.forename: Yue-Cune
authors.initials: YC
authors.lastname: Chang
authors.forename: Liang-Wen
authors.initials: LW
authors.lastname: Sun
mesh_terms: D001942:Breast Feeding; D006365:Heel; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D010146:Pain; D013624:Taiwan