Non-nutritive sucking relieves pain for preterm infants during heel stick procedures in Taiwan.
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.
Liaw
Jen-Jiuan
JJ
School of Nursing, National Defense Medical Center, Taipei, Taiwan.
Yang
Luke
L
Ti
Yin
Y
Blackburn
Susan Tucker
ST
Chang
Yue-Cune
YC
Sun
Liang-Wen
LW
D001942:Breast Feeding; D006365:Heel; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D010146:Pain; D013624:Taiwan