The Efficiency of Using Supportive Postures and Holding Techniques to Minimize Premature Infant Pain (PAP)
The Efficiency of Using Supportive Postures and Holding Techniques to Minimize Premature Infant Pain (PAP)
Out of the most commonly performed procedures in neonates, naso-gastric tube insertion is
 rated as the fifth most painful. The pain is often under estimated due to the frequency with
 which the procedure is carried out. It has been shown that the environment in which the
 procedure is performed (e.g with skin to skin contact and specific positioning), reduces the
 discomfort felt by the newborn. However, this has not yet been proven with regards to
 naso-gastric tube insertion.
Our clinical study (carried out in the Neonatology Unit of Mercy Regional Hospital) has shown
 that when positioning and other non drug related analgesic techniques are used, newborns
 undergoing naso-gastric tube insertion feel less pain.

 Several different techniques were used, such as skin-to-skin contact with the mother and/or
 positioning the infant using appropriate equipment, or the "four hands" technique carried out
 by two health care professionals.

 Neonatal unit staff were able to choose the method used depending on whether the mother was
 present at the time of the procedure.

 In cases where the mother was absent, the "four hands technique" was favored, but in the
 presence of the mother skin-to-skin contact was preferable.
Inclusion Criteria:

 -  Preterm baby born between the 32th and the 35th weeks of amenorrhea plus 6 days

 -  Prescription of enteral nutrition via naso-gastric tube

 -  Naso-gastric tube in-situ

 -  Informed consent of both parents

 Exclusion Criteria:

 For the newborn

 -  Under respiratory assistance

 -  With nasal or buccal malformation

 -  With abnormal heart rhythm or congenital heart disease

 -  With hemodynamic instability

 -  Transfer to type 3 neonatal unit

 -  With a DAN score > 0 before treatment

 -  With an umbilical venous catheter in-situ

 -  Fed with thickened milk

 -  Prescription of analgesic medications

 For the parents

 -  Minor

 -  Under legal protection

 -  Difficulties which do not permit the mother to carry out skin-to skin contact or
 holding support