A systematic review and network meta-analysis of non-pharmacological interventions involving parents on pain during invasive procedures among newborns

Purpose: The current study performed a network meta-analysis to investigate the relative effectiveness of non-pharmacological interventions involving parents in alleviating discomfort in neonates. Design: and Methods: The databases searching from Pubmed, Science Direct, Cochrane, Embase, Scopus, CINAHL, Sage, and Clinical Key were conducted from inception to August 2023. We considered infants who have completed at least 37 weeks of gestation and have had invasive procedures in the Neonatal Intensive Care Unit (NICU). Non-randomized controlled trial studies were excluded from this review. A frequentist framework was used to conduct a network meta-analysis with random effects. Results: In total, 35 RCTs with 4790 participants were included. The three most effective non-pharmacological interventions reducing neonatal pain during invasive procedures are breastfeeding, combination breastfeeding and mother holding, combination breastfeeding and music therapy, mother holding, and sweet solution. These interventions have been shown to have a significant impact on pain reduction, with standardized mean differences ranging from −5.20 to −3.48 (Standardized Mean Difference (SMD): 2.0, 95% Confidence Interval (CI): 2.7 to −1.3; SMD: 3.0, 95% CI: 6.0 to −0.02; SMD: 4.9, 95% CI: 7.3 to −2.6; SMD: 1.5, 95%CI: 2.9 to −0.06; SMD: 1.4, 95%CI: 2.4 to −0.5 respectively). Practice implications: Non-pharmacological therapies such as breastfeeding, a combination of breastfeeding and mother holding, a combination of breastfeeding and music therapy, mother holding alone, as well as a sweet solution are effective in reducing pain in babies undergoing invasive procedures. Healthcare professionals may involve parents in the administration of these treatments during the carrying out of such procedures.