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The Impact of Pacifiers and Positioning on Pain Management in Neonates: Meta-Analysis

Shahla Shafaati Laleh1, Aysu Yildiz Karaahmet2

  • 1Departmen of Midwifery, Istanbul University-Cerrahpaşa, Graduate Education Institute, Istanbul, Turkey; Azad University of Mahabad, mahabad, Iran.

Pain Management Nursing : Official Journal of the American Society of Pain Management Nurses
|March 29, 2025
PubMed

Insights

Individualized Supportive Developmental Care (ISDC) effectively reduces pain in newborns during procedures. This meta-analysis confirms that pacifiers and specific positioning significantly lower pain scores in infants, promoting better developmental outcomes.

Area of Science:

  • Neonatal care
  • Developmental pediatrics
  • Pain management

Background:

  • Individualized Supportive Developmental Care (ISDC) is a model designed to enhance neurological development and organization in preterm infants.
  • Managing procedural pain is crucial for optimal infant outcomes.
  • Pacifier use and positioning are common non-pharmacological interventions in neonatal care.

Purpose of the Study:

  • To systematically review and meta-analyze the evidence on Individualized Supportive Developmental Care (ISDC) for managing newborn pain.
  • To specifically examine the impact of pacifier use and positioning within ISDC on pain reduction.
  • To synthesize findings from existing research to inform clinical practice.

Main Methods:

  • A systematic review and meta-analysis were conducted.
  • Searched five databases for relevant studies including randomized controlled trials, experimental studies, and semi-experimental designs.
  • Included studies focused on neonatal infants and ISDC interventions like pacifier use and positioning. Data extraction was performed by two independent reviewers.

Main Results:

  • Twelve studies met the inclusion criteria for the meta-analysis.
  • ISDC significantly reduced pain during procedures, with a meaningful difference in pain assessment (SMD: -1.15).
  • Subgroup analyses showed significant pain reduction with prone positioning (SMD: -1.34) and pacifier use (SMD: -0.83), particularly in infants >37 weeks gestation.

Conclusions:

  • Meta-analysis results provide strong evidence that ISDC, incorporating pacifiers and positioning, effectively reduces pain in newborns during procedures.
  • These non-pharmacological interventions are valuable tools for improving the care of infants undergoing painful procedures.
  • Further research may explore optimal protocols for ISDC implementation to maximize pain relief.
Abstract

Keywords:
DummyEmpty teatGloved fingerMeta-analysisNewbornPacifiersPainPersonalized supportive developmental carePositioning

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