To Örebro University

Background: For improving the management of infant pain and translating research into practice, parents’ active involvement during painful procedures is considered a critical first step. Research into parents’ motivations for and experiences of alleviating infant pain, is scarce. More research on combined parent-delivered pain alleviation including relationship-based interventions such as the parent’s musical presence is needed to advance infant pain care.

Aim: Parents as pain management in Swedish neonatal care (SWEpap), is a new cutting-edge interdisciplinary multi-center clinical study. Using a mixed methods approach, SWEpap investigates parent-delivered interventions such as infant-directed lullaby singing, breastfeeding and skin-to-skin contact where parents themselves mediate pain relief. This approach is consistent with a modern understanding of pain and of family-integrated care.

Material and method: The qualitative part of the SWEpap study applies collaborative participatory action research design, video observations and interviews to investigate health care professionals’ and parents’ motivational factors in and experiences of parent- delivered pain alleviation. The second part is a randomized controlled trial. The RCT will investigate the efficacy of combined pain management with live parental lullaby singing, breastfeeding and skin-to-skin contact compared with standard pain care during routine blood sampling of newborn infants. The enrollment has started and is expected to be completed during 2023.

Results: Preliminary results acknowledge the need for parents to be educated and prepared about the effectiveness of the parent-delivered methods and how to apply them prior to the procedure. In addition, when preparing for the actual procedure, both parents and health care professionals emphasize the importance of allowing the parents sufficient time to cope with the situation and the dyad to relax before the skin puncture.

Conclusion: Video observations and interviews with parents and health care professionals indicate that parent- delivered interventions such as infant-directed lullaby singing, breastfeeding and skin-to-skin contact are feasible pain treatment methods during painful procedures.