Table 9.

Recommendations in clinical guidelines.

Author (year), country	Issued by	Breastfeeding	Breast milk	Facilitated tucking	Holding or swaddling	Massage	Live parental infant-directed singing	Skin-to-skin contact	Combined parent-delivered interventions
Lago et al. (83), Italy	Pain study group of the Italian Society of Neontatologya	A	A	C	Maternal touching and holding D, swaddling C			B	Sensorial saturation: B
Spence et al. (125), Australia	The Australian and New Zealand Neonatal Networkb	I	I
Nyqvist et al. (126), Sweden	First European Conference and Seventh International Workshop on Kangaroo Mother Care								x
Academy of Breastfeeding Medicine (127), USA	The Academy of Breastfeeding Medicine Protocol Committee	x	x					x
Howard et al. (84), UK	Association of Pediatric Anesthetists of Great Britain and Irelanda	A			A	A		A
Baley (85), USA	American Academy of Pediatrics							x
Keels et al. (128), USA	American Academy of Pediatrics	x	x	x		x			x
Roue et al. (129), France	The European Network on Early Developmental Care	x		x	x			x

The guidelines do not state whether parents or staff provide the pain-alleviating intervention. ^aLevel of evidence and grades of recommendation ranging from A to D based on the Scottish Intercollegiate Guidelines Network classification. A represents the highest and D represents the lowest grade of recommendation. ^bLevels of evidence and quality of evidence according to the National Health and Medical Research Council where I means evidence obtained from a systematic review. x denotes the intervention is suggested in the guidelines.