SWEpap - Parents, a pain-relieving resource in neonatal care

During the most vulnerable period in a child’s life, preterm and sick infants are exposed to a high number of painful procedures, sometimes without the comfort of their parents. Since repeated pain and frequent use of analgesic drugs may have consequences for the neurological and behaviour-oriented development of the infant, it is vital to identify effective non-pharmacological pain-relieving interventions. The study “Parents as pain management in Swedish neonatal care (SWEpap)” is a cutting-edge interdisciplinary multicentre clinical study in two parts with mixed methods involving parents, infants and health professionals.

The first part of SWEpap was a participatory action research study investigating parents’ and nurses’ perceptions of combined parent-delivered pain management with breastfeeding (when applicable), skin-to-skin contact, and parents’ infant-directed lullaby singing, during painful procedures in neonatal care. Mental and practical preparations were found to be the key to facilitating combined parent-delivered pain management. The parents’ lullaby singing during the procedure created a calm and trusting atmosphere for infants, parents and nurses. When parents and nurses explored the interventions, they found the methods feasible, promoting self-efficacy and confidence in both parents and nurses. This is the first study exploring healthcare professionals’ and parents’ views and reflections on experiencing combined parent-delivered methods in which live parental lullaby singing is included.

The second part of SWEpap, was a multicentre randomized controlled trial (RCT) with three parallel groups including 225 parent-infant dyads investigating the efficacy of combined parent-delivered pain management with skin-to-skin contact, breastfeeding and live parental lullaby singing compared with standard pain care initiated by health care professionals, during routine metabolic screening of newborn infants (PKU-test). Pain scores remained within the mild to moderate range across all groups, with the infants receiving oral glucose having significantly lower pain scores. Parent-delivered pain management combining skin-to-skin contact, breastfeeding, and parents’ live lullaby singing is a feasible and safe intervention with pain alleviating properties offering the parents a strong sense of meaningfulness and stress relief.

Published results from the SWEpap study part 1 can be read here. Published results from the SWEpap study part 2 can be read here.

Study protocol.