Painful procedures experienced by preterm newborns and evidence-based non-pharmacological methods

Abstract

Preterm newborns are defined as babies born alive before 37 weeks of pregnancy are completed. Prolonged or frequent pain in the early stages of life can prevent the baby’s behaviour, feeding patterns, adaptation to the outside world, as well as changes in brain development and adversely affect growth. Preterm newborns are known to be more sensitive to pain due to immature pain mechanisms. Therefore, preterm newborns need more support during painful procedures. The aim of this review is to provide information about the painful procedures encountered by preterm newborns in neonatal intensive care units and the evidence-based non-pharmacological methods for these painful procedures. This study used English–Turkish language articles and a search was conducted in PubMed, Scopus, Cochrane and Google Scholar, using a combination of key words like ‘painful procedures’, ‘preterm newborn’, ‘non-pharmacological methods’ and ‘pain and newborn’. These terms are frequently used in non-pharmacological methods as well as pharmacological methods in pain relief. Non-pharmacologic methods used in pain management in preterm neonates are massage, kangaroo care, music, oral sucrose, pacifier, aromatherapy, swaddling, facilitated tucking, prone position, mother’s touch, mother’s voice and smell and breastfeeding method. Facilitated tucking, kangaroo care, swaddling, breast milk and oral sucrose are effective in heel blood collection and venous blood collection in newborns. It has been reported in the literature that the smell of glucose, breast milk, vanilla and lavender reduces pain. It is stated in the literature that breast milk, sucrose and kangaroo care used during the retinopathy of premature retinopathy reduces pain during and after the procedure. The aim of newborn pain management is to help reduce pain and help the baby cope with pain. Therefore, further research on evidence-based non-pharmacological methods is essential, and it is essential for all health professionals to be aware, know and practice non-pharmacological methods.   Keywords: Newborn; pain; non-pharmacological methods; preterm;