Table 8.
Evidence for parent-delivered interventions: combined parent-delivered interventions.
| Author (year), country | Study design | Population, setting | Type of pain, intervention | Key findings |
|---|---|---|---|---|
| Bellieni et al. (76), Italy | RCT | 66 full-term infants, nursery | Heel prick, (1) sensorial saturation without perfume performed by nurses, (2) sensorial saturation without perfume performed by mothers, and (3) glucose plus sucking | Sensorial saturation performed by mothers as effective as that performed by experienced nurses |
| Johnston et al. (67), Canada | Randomized crossover | 90 preterm infants, GA 32–36 weeks, NICU | Heel lance, SSC mother compared with enhanced SSC with rocking, infant-directed speech/infant-directed singing, and sucking | PIPP scores in both groups in the minor pain strata, but no between- group differences |
| Okan et al. (121), Turkey | RCT | 107 full-term infants, maternity ward | Heel lance, (1) breastfeeding with SSC combined with touching the infants' heads and backs and talking to the infant whenever the mothers wished, (2) maternal holding with SSC but no breastfeeding, and (3) no-contact group with the infants lying on an examination table | HR, SaO2, and length of crying were significantly lower in groups 1 and 2 than in group 3, but no difference found between groups 1 and 2 |
| Marín Gabriel et al. (73), Spain | RCT | 136 full-term infants, maternity ward | Heel lance, (1) breastfeeding and SSC, (2) oral sucrose and SSC, (3) SSC alone, and (4) oral sucrose alone | Lower NIPS score in the breastfeeding and SSC group compared with other groups |
| Obeidat et al. (74), Jordan | RCT | 128 full-term infants, maternity ward | Heel lance, (1) breastfeeding combined with maternal holding and (2) maternal holding, on mothers' lap, alone | Lower PIPP score with combined breastfeeding and maternal holding |
| Leite et al. (75), Brazil | RCT | 55 full-term newborns, maternity ward | Hepatitis B vaccination, (1) SSC and (2) breastfeeding with SSC | Breastfeeding in combination with SSC showed lower HR than breastfeeding alone; lower NFCS after the injection |
| Bembich et al. (47), Italy | RCT | 80 full-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 | Different cortical patterns (NIRS) were evoked in the four groups Glucose and breast milk are more effective when combined with the maternal–infant relationship than when given alone |
| Yilmaz and Inal (55), Turkey | RCT | 160 full-term 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 |
RCT, randomized control trial; GA, gestational age; NICU, neonatal intensive care unit; SSC, skin-to-skin contact; PIPP, premature infant pain profile; HR, heart rate; SaO2, oxygen saturation; NIPS, Neonatal Infant Pain Score; NFCS, Neonatal Facial Coding System; NIRS, near-infrared spectroscopy.