How you can help your baby during painful or stressful procedures

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How can we reduce pain, stress and discomfort for your baby?

While your baby is here on the neonatal unit, it may be necessary for the nursing and medical team to perform various procedures, such as taking blood samples or putting in drips (cannulae). Research has shown that even premature babies are capable of experiencing pain. Therefore, we aim, as far as possible, to minimise any potential discomfort. Medicine(s) may be used to help control pain. However, pain, stress and discomfort may also be reduced without medicine(s). These include the use of containment holding also called comfort holding, skin to skin (kangaroo) cuddles, nesting, positioning, non-nutritive sucking, pacifiers, sucrose and by minimising noise and light.

How can you help your baby?

At times, it may not be appropriate or possible for us to give your baby medicine(s) to reduce pain. This may be because of their age or condition so other measures, such as those described below, also play an important role. Even when we can use medicine(s), these other methods can help to reduce pain or distress further.
When you are with your baby on the Unit, you may wish to try some of these techniques. The nurses and doctors can advise you which of these measures may be most appropriate for your baby, depending on the procedure, as well as their age and condition. They can help you to decide how you choose to comfort your baby. Alternatively, when you are not available or if you would prefer not to be present during these procedures, one of the nurses or doctors may use some of these comforting measures on your behalf.

What is containment holding (comfort holding)?

Containment holding (comfort holding) is a way of ensuring your baby feels secure and involves a still hold, with hands cupped around your baby’s head and across their hips or bottom.

What happens during a skin to skin (kangaroo) cuddle?

A skin to skin cuddle involves holding your baby, dressed in only a nappy and hat (if required for extra warmth) against your bare chest, similar to a kangaroo carrying their young. This skin to skin contact ensures that your baby is kept warm and can also help with bonding. Babies in this position are often in a restful state and this can help to reduce some of the stress factors associated with the neonatal unit. This technique has not been shown to have any physical risks to babies.

How can I position/nest my baby to reduce stress?

Newborn babies, particularly when they are premature or unwell, feel more secure and will be less stressed when they are positioned with their legs tucked up, arms bent, and hands brought together in front of their face. They prefer to be touching or lying up against something and will often move in the cot or incubator until they find a boundary. By positioning your baby in this foetal position and providing boundaries, you can help your baby to feel calm and comfortable. The nursing staff can show you how to use blankets and sheets or nesting aids to achieve this comforting position for your baby.

What is non-nutritive sucking?

This is a term which describes when your baby sucks on a finger, nipple, pacifier or teat (with your consent) even though they may not be gaining nutrition while they suck. Please ask a member of the neonatal team should you wish to know more about the benefits of non-nutritive sucking.

How can I help reduce the noise and light?

We provide dark cloth covers for your babies’ incubator or cot to reduce the light and noise entering their space. These covers may be removed when you visit so that you can see your baby. When the nurses and doctors need to perform procedures e.g. inserting drips, on your baby, they can cover your baby’s eyes to protect them from the bright light. You may talk quietly to your baby but try to avoid having long conversations with friends and family close to or across the incubator or cot, as these may disturb your baby.

How can sucrose help to relieve pain?

Sucrose (a sweet tasting solution) is thought to produce a natural release of the body’s own painkillers when put onto the tongue. It may help to reduce crying and other signs of pain in babies. We may be able to give sucrose instead of other stronger painkillers for some minor procedures. There is a separate information leaflet available about the use of sucrose to reduce pain. Please ask a member of staff should you wish to read this leaflet.

Who decides whether my baby will benefit from these measures to reduce pain?

This decision will depend on the age and condition of your baby and may change from day to day or even hour to hour. It will also depend on the procedure that has to be performed. The nurses and doctors can discuss this with you and together you can decide whether your baby will benefit from these measures. Your baby will also let you know when they are tired and need to rest. We can help you to recognise these signs.