Table 4.
Evidence for parent-delivered interventions: holding or swaddling.
| Author (year), country | Study design | Population, setting | Type of pain, intervention | Key findings |
|---|---|---|---|---|
| Karakoç et al. (60), Turkey | 3-group experiment without randomization | 120 full-term newborn infants, maternity ward | Blood sampling outer side of left foot, maternal holding on the mothers' laps vs. maternal holding and recorded white noise vs. recorded white noise in crib | Higher NIPS score and longer crying time for the maternal holding group compared with the white noise-only group |
| Bembich et al. (61), Italy | RCT | 40 full-term newborn infants, postnatal ward | Heel prick, mothers holding the dressed infant in their arms vs. oral glucose (on examination table) | Maternal holding was associated with cortical activation in areas associated with the processing of somatic sensations and, in newborns, with affective responses (NIRS). Mother–infant relationship can improve the analgesic effect |
| Hashemi et al. (43), Iran | RCT | 131 term neonates, vaccination unit | BCG vaccination, swaddling vs. breastfeeding 45 min before vaccination vs. combination swaddling and breastfeeding vs. control (no intervention) | Lower NFCS scores than control |
| Bembich et al. (47), Italy | RCT | 80 term newborns, nursery | Heel stick, (1) oral glucose on changing table, (2) maternal expressed breast milk on changing table, (3) maternal holding plus oral glucose, and (4) breastfeeding | Lower NIPS scores in the holding plus breastfeeding group than in the other groups |
| Jones et al. (31), UK | Observational | 27 infants, GA 23–41 weeks, neonatal unit | Heel lance, held by parent with clothing vs. SSC mother vs. control (lying in cot) | No difference in effect on magnitude in noxious-related cortical activity (EEG) compared with lying in cot |
| Roshanray et al. (61), Iran | RCT | 135 full-term newborn infants, health center | Blood sampling, mothers holding the infant in their arms (hug group) vs. massage vs. control (no intervention) | No difference in NIPS score immediately after blood sampling. After 5 min, lower NIPS in mother's hug group compared with the massage and control groups |
| Yilmaz and Inal (55), Turkey | RCT | 169 term newborn infants, maternity ward | Heel lance, (1) control group without analgesia, (2) swaddling, (3) swaddling and maternal holding,and (4) swaddling and maternal holding and breastfeeding | Lower NIPS score with combined swaddling, maternal holding and breastfeeding compared to all other groups Duration of crying and calming time were shorter with combined swaddling, maternal holding, and breastfeeding than in all other groups |
NIPS, Neonatal Infant Pain Scale; RCT, randomized control trial; NIRS, near-infrared spectroscopy; NFCS, Neonatal Facial Coding System; GA, gestational age; EEG, electroencephalogram.