Psychosocial and Neurobiological Vulnerabilities of the Hospitalized Preterm Infant and Relevant Non-pharmacological Pain Mitigation Strategies

Ilana Shiff,Oana Bucsea,Rebecca Pillai Riddell

doi:10.3389/fped.2021.568755

Ilana Shiff, Oana Bucsea + Show 1 more

Open Access

https://doi.org/10.3389/fped.2021.568755

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Abstract

Background: Preterm pain is common in the Neonatal Intensive Care Unit (NICU), with multiple invasive procedures occurring daily.Objective: To review the psychosocial and neurobiological vulnerabilities of preterm infants and to provide an updated overview of non-pharmacological strategies for acute procedural pain in hospitalized preterm infants.Methods: We utilized a narrative review methodology, which also included a synthesis of key pieces of published systematic reviews that are relevant to the current work.Results and Conclusions: Preterm infants are uniquely susceptible to the impact of painful procedures and prolonged separation from caregivers that are often inherent in a NICU stay. Non-pharmacological interventions can be efficacious for mitigating procedural pain for preterm infants. Interventions should continue to be evaluated with high quality randomized controlled trials, and should endeavor to take into account the neurobiological and psychosocial aspects of preterm vulnerability for pain prevention and management strategies.

Highlights

Pain in the preterm infant is a widespread challenge
The current paper focuses on reviewing the biopsychosocial factors involved in preterm infant development as a means to contextualize professional understanding of non-pharmacological approaches to managing infant pain and mitigating the associated sequelae for both children and families
Reference will be made to the published results from a 2015 Cochrane Review entitled “Non-pharmacological management of infant and young child procedural pain” [72], relevant reviews [e.g., [73,74,75]], and new trials that we have found in a recent literature search

Summary

Results and Conclusions

Preterm infants are uniquely susceptible to the impact of painful procedures and prolonged separation from caregivers that are often inherent in a NICU stay. Non-pharmacological interventions can be efficacious for mitigating procedural pain for preterm infants. Interventions should continue to be evaluated with high quality randomized controlled trials, and should endeavor to take into account the neurobiological and psychosocial aspects of preterm vulnerability for pain prevention and management strategies

INTRODUCTION

DISCUSSION

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