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Meta-Analysis
. 2017 Feb 16;2(2):CD008435.
doi: 10.1002/14651858.CD008435.pub3.

Skin-to-skin care for procedural pain in neonates

Celeste Johnston  1 , Marsha Campbell-Yeo  2 , Timothy Disher  3 , Britney Benoit  3 , Ananda Fernandes  4 , David Streiner  5 , Darlene Inglis  2 , Rebekah Zee  2
Affiliations
Meta-Analysis

Skin-to-skin care for procedural pain in neonates

Celeste Johnston et al. Cochrane Database Syst Rev. .

Abstract

Background: Skin-to-skin care (SSC), often referred to as 'kangaroo care' (KC) due to its similarity with marsupial behaviour of ventral maternal-infant contact, is one non-pharmacological intervention for pain control in infants.

Objectives: The primary objectives were to determine the effect of SSC alone on pain from medical or nursing procedures in neonates compared to no intervention, sucrose or other analgesics, or additions to simple SSC such as rocking; and to determine the effects of the amount of SSC (duration in minutes), method of administration (e.g. who provided the SSC) of SSC in reducing pain from medical or nursing procedures in neonatesThe secondary objectives were to determine the safety of SSC care for relieving procedural pain in infants; and to compare the SSC effect in different postmenstrual age subgroups of infants.

Search methods: For this update, we used the standard search strategy of the Cochrane Neonatal Review group to search the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 1); MEDLINE via PubMed (1966 to 25 February 2016); Embase (1980 to 25 February 2016); and CINAHL (1982 to 25 February 2016). We also searched clinical trials' databases, conference proceedings, and the reference lists of retrieved articles for randomized controlled trials and quasi-randomized trials.

Selection criteria: Studies with randomisation or quasi-randomisation, double- or single-blinded, involving term infants (≥ 37 completed weeks' postmenstrual age (PMA) to a maximum of 44 weeks' PMA and preterm infants (< 37 completed weeks PMA) receiving SSC for painful procedures conducted by healthcare professionals.

Data collection and analysis: The main outcome measures were physiological or behavioural pain indicators and composite pain scores. A mean difference (MD) with 95% confidence interval (CI) using a fixed-effect model was reported for continuous outcome measures. We included variations on type of tissue-damaging procedure, provider of care, and duration of SSC.

Main results: Twenty-five studies (n = 2001 infants) were included. Nineteen studies (n = 1065) used heel lance as the painful procedure, one study combined venepuncture and heel stick (n = 50), three used intramuscular injection (n = 776), one used 'vaccination' (n = 60), and one used tape removal (n = 50). The studies were generally strong and had low or uncertain risk of bias. Blinding of the intervention was not possible, making them subject to high risk, depending on the method of scoring outcomes.Seventeen studies (n = 810) compared SSC to a no-treatment control. Although 15 studies measured heart rate during painful procedures, data from only five studies (n = 161) could be combined for a mean difference (MD) of -10.78 beats per minute (95% CI -13.63 to -7.93) favouring SSC. Meta-analysis of four studies (n = 120) showed no difference in heart rate following the painful procedure (MD 0.08, 95% CI -4.39 to 4.55). Two studies (n = 38) reported heart rate variability with no significant differences. Two studies (n = 101) in a meta-analysis on oxygen saturation at 30 and 60 seconds following the painful procedure did not show a difference. Duration of crying meta-analysis was performed on four studies (n = 133): two (n = 33) investigated response to heel lance (MD = -34.16, 95% CI -42.86 to -25.45), and two (n = 100) following IM injection (MD = -8.83, 95% CI -14.63 to -3.02), favouring SSC. Five studies, one consisting of two substudies (n = 267), used the Premature Infant Pain Profile (PIPP) as a primary outcome, which favoured SCC at 30 seconds (MD -3.21, 95% CI -3.94 to -2.47), at 60 seconds (3 studies; n = 156) (MD -1.64, 95% CI -2.86 to -0.43), and at 90 seconds (n = 156) (MD -1.28, 95% CI -2.53 to -0.04); but at 120 seconds there was no difference (n = 156) (MD 0.07, 95% CI -1.11 to 1.25). No studies on return of heart rate to baseline level, cortisol levels, and facial actions could be combined for meta-analysis findings.Eight studies compared SSC to another intervention with or without a no-treatment control. Two cross-over studies (n = 80) compared mother versus other provider (father, another female) on PIPP scores at 30, 60, 90, and 120 seconds with no significant difference. When SSC was compared to other interventions, there were not enough similar studies to pool results in an analysis. One study compared SSC (n = 640) with and without dextrose and found that the combination was most effective and that SSC alone was more effective than dextrose alone. Similarly, in another study SSC was more effective than oral glucose for heart rate (n = 95). SSC either in combination with breastfeeding or alone was favoured over a no-treatment control, but not different to breastfeeding. One study compared SSC alone and in combination with both sucrose and breastfeeding on heart rate (HR), NIPS scores, and crying time (n = 127). The combinations were more effective than SSC alone for NIPS and crying. Expressed breast milk was compared to SSC in one study (n = 50) and found both equally effective on PIPP scores. There were not enough participants with similar outcomes and painful procedures to compare age groups or duration of SSC. No adverse events were reported in any of the studies.

Authors' conclusions: SSC appears to be effective as measured by composite pain indicators with both physiological and behavioural indicators and, independently, using heart rate and crying time; and safe for a single painful procedure. Purely behavioural indicators tended to favour SSC but with facial actions there is greater possibility of observers not being blinded. Physiological indicators were mixed although the common measure of heart rate favoured SSC. Two studies compared mother-providers to others, with non-significant results. There was more heterogeneity in the studies with behavioural or composite outcomes. There is a need for replication studies that use similar, clearly defined outcomes. Studies examining optimal duration of SSC, gestational age groups, repeated use, and long-term effects of SSC are needed. Of interest would be to study synergistic effects of SSC with other interventions.

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Conflict of interest statement

The authors have nothing to declare.

Figures

1
1
Study flow diagram: review update
2
2
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
1.1
1.1. Analysis
Comparison 1 Skin‐to‐skin care versus control, Outcome 1 Heart Rate during painful procedure.
1.2
1.2. Analysis
Comparison 1 Skin‐to‐skin care versus control, Outcome 2 Heart rate following painful procedure.
1.3
1.3. Analysis
Comparison 1 Skin‐to‐skin care versus control, Outcome 3 HRV during painful procedure ‐ Low frequency power.
1.4
1.4. Analysis
Comparison 1 Skin‐to‐skin care versus control, Outcome 4 HRV during painful procedure ‐ High frequency power.
1.5
1.5. Analysis
Comparison 1 Skin‐to‐skin care versus control, Outcome 5 HRV during painful procedure ‐ Low frequency to high frequency ratio.
1.6
1.6. Analysis
Comparison 1 Skin‐to‐skin care versus control, Outcome 6 HRV after painful procedure ‐ Low frequency power.
1.7
1.7. Analysis
Comparison 1 Skin‐to‐skin care versus control, Outcome 7 HRV after painful procedure ‐ High frequency power.
1.8
1.8. Analysis
Comparison 1 Skin‐to‐skin care versus control, Outcome 8 HRV after painful procedure ‐ Low frequency to high frequency ratio.
1.9
1.9. Analysis
Comparison 1 Skin‐to‐skin care versus control, Outcome 9 Oxygen saturation 30 seconds after painful procedure.
1.10
1.10. Analysis
Comparison 1 Skin‐to‐skin care versus control, Outcome 10 Oxygen saturation 60 seconds after painful procedure.
1.11
1.11. Analysis
Comparison 1 Skin‐to‐skin care versus control, Outcome 11 PIPP Score 30 seconds after painful procedure.
1.12
1.12. Analysis
Comparison 1 Skin‐to‐skin care versus control, Outcome 12 PIPP Score 60 seconds after painful procedure.
1.13
1.13. Analysis
Comparison 1 Skin‐to‐skin care versus control, Outcome 13 PIPP Score 90 seconds after painful procedure.
1.14
1.14. Analysis
Comparison 1 Skin‐to‐skin care versus control, Outcome 14 PIPP Score 120 seconds after painful procedure.
1.15
1.15. Analysis
Comparison 1 Skin‐to‐skin care versus control, Outcome 15 NIPS ‐ Proportion of infants in low or no pain during procedure.
1.16
1.16. Analysis
Comparison 1 Skin‐to‐skin care versus control, Outcome 16 NIPS ‐ Infants in severe pain following procedure.
1.17
1.17. Analysis
Comparison 1 Skin‐to‐skin care versus control, Outcome 17 NIPS ‐ Infants in no pain during recovery.
1.18
1.18. Analysis
Comparison 1 Skin‐to‐skin care versus control, Outcome 18 NIPS ‐ Infants in severe pain during recovery.
1.19
1.19. Analysis
Comparison 1 Skin‐to‐skin care versus control, Outcome 19 Duration of cry (seconds) following heel lance.
1.20
1.20. Analysis
Comparison 1 Skin‐to‐skin care versus control, Outcome 20 Duration of cry (seconds) following IM injection.
2.1
2.1. Analysis
Comparison 2 Skin‐to‐skin care with different providers, Outcome 1 Heart rate recovery.
2.2
2.2. Analysis
Comparison 2 Skin‐to‐skin care with different providers, Outcome 2 PIPP Score 30 seconds.
2.3
2.3. Analysis
Comparison 2 Skin‐to‐skin care with different providers, Outcome 3 PIPP Score 60 seconds.
2.4
2.4. Analysis
Comparison 2 Skin‐to‐skin care with different providers, Outcome 4 PIPP Score 90 seconds.
2.5
2.5. Analysis
Comparison 2 Skin‐to‐skin care with different providers, Outcome 5 PIPP Score 120 Seconds.
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References

References to studies included in this review

Akcan 2009 {published data only}
    1. Akcan E, Yiğit R, Atici A. The effect of kangaroo care on pain in premature infants during invasive procedures. Turkish Journal of Pediatrics 2009;51(1):14‐8. - PubMed
Castral 2008 {published and unpublished data}
    1. Castral TC, Warnock F, Leite AM, Haas VJ, Scochi CG. The effects of skin‐to‐skin contact during acute pain in preterm newborns. European Journal of Pain 2008;12(4):464‐71. - PubMed
Chermont 2009 {published and unpublished data}
    1. Chermont AG, Falcão LF, Souza Silva EH, Cássia Xavier Balda R, Guinsburg R. Skin‐to‐skin contact and/or oral 25% dextrose for procedural pain relief for term newborn infants. Pediatrics 2009;124(6):e1101‐7. - PubMed
Cong 2009 {published and unpublished data}
    1. Cong X, Ludington‐Hoe SM, McCain G, Fu P. Kangaroo care modifies preterm infant heart rate variability in response to heel stick pain: Pilot study. Early Human Development 2009;85(9):561‐7. - PMC - PubMed
Cong 2011 {published and unpublished data}
    1. Cong X, Ludington‐Hoe SM, Walsh S. Randomized crossover trial of kangaroo care to reduce biobehavioural pain responses in preterm infants: a pilot study. Biological Research for Nursing 2011;13(2):204‐16. - PubMed
Cong 2012 {published data only}
    1. Cong X, Cusson RM, Walsh S, Hussain N, Ludington‐Hoe SM, Zhang D. Effects of skin‐to‐skin contact on autonomic pain responses in preterm infants. The Journal of Pain 2012;13(7):636‐45. - PubMed
Freire 2008 {published and unpublished data}
    1. Freire NB, Garcia JB, Lamy ZC. Evaluation of analgesic effect of skin‐to‐skin contact compared to oral glucose in preterm neonates. Pain 2008;139(1):28‐33. - PubMed
Gabriel 2013 {published data only}
    1. Marin Gabriel MA, Rey Hurtado de Mendoza B, Jimenez Figueroa L, Medina V, Iglesias Fernández, B, Vazquez Rodríguez M, et al. Analgesia with breastfeeding in addition to skin‐to‐skin contact during heel prick. Archives of Diseases in Childhood. Fetal and Neonatal Edition 2013;98(6):F499‐503. [DOI: ] - PubMed
Gao 2015 {published data only}
    1. Gao H, Xu G, Gao H, Dong R, Fu H, Wang D, et al. Effect of repeated Kangaroo Mother Care on repeated procedural pain in preterm infants: A randomized controlled trial. International Journal of Nursing Studies 2015;Epub ahead of print(7):1157‐65. - PubMed
Gray 2000 {published data only}
    1. Gray L, Watt L, Blass EM. Skin‐to‐skin contact is analgesic in healthy newborns. Pediatrics 2000;105(1):e14. - PubMed
Johnston 2003 {published and unpublished data}
    1. Johnston CC, Stevens B, Pinelli J, Gibbins S, Filion F, Jack A, et al. Kangaroo care is effective in diminishing pain response in preterm neonates. Archives of Pediatrics & Adolescent Medicine 2003;157(11):1084‐8. - PubMed
Johnston 2008 {published and unpublished data}
    1. Johnston CC, Filion F, Campbell‐Yeo M, Goulet C, Bell L, McNaughton K, et al. Kangaroo mother care diminishes pain from heel lance in very preterm neonates: a crossover trial. BMC Pediatrics 2008;8:13. - PMC - PubMed
Johnston 2009 {published and unpublished data}
    1. Johnston CC, Filion F, Campbell‐Yeo M, Goulet C, Bell L, McNaughton K, et al. Enhanced kangaroo mother care for heel lance in preterm neonates: a crossover trial. Journal of Perinatology 2009;29(1):51‐6. - PubMed
Johnston 2011 {published and unpublished data}
    1. Johnston CC, Campbell‐Yeo M, Filion F. Paternal vs maternal kangaroo care for procedural pain in preterm neonates: A randomized crossover trial. Archives of Pediatrics & Adolescent Medicine 2011;165(9):792‐6. - PubMed
Johnston 2012 {published and unpublished data}
    1. Johnston C, Byron J, Filion F, Campbell‐Yeo M, Gibbins S, Ng E. Alternative female kangaroo care for procedural pain in preterm neonates: A pilot study. Acta Paediatrica 2012;101(11):1147‐50. - PubMed
Kostandy 2008 {published data only}
    1. Kostandy RR, Ludington‐Hoe SM, Cong X, Abouelfettoh A, Bronson C, Stankus A, et al. Kangaroo Care (skin contact) reduces crying response to pain in preterm neonates: pilot results. Pain Management Nursing 2008;9(2):55‐65. - PMC - PubMed
Kostandy 2013 {published and unpublished data}
    1. Kostandy R, Anderson GC, Good M. Skin‐to‐skin contact diminishes pain from hepatitis B vaccine injection in healthy full‐term neonates. Neonatal Network 2013;32(4):274‐80. [PUBMED: 23835546] - PubMed
Liu 2015 {published data only}
    1. Liu M, Zhao L, Li XF. Effect of skin contact between mother and child in pain relief of full‐term newborns during heel blood collection. Clinical and Experimental Obstetrics & Gynecology 2015;XLII(3):304‐8. [DOI: 10.12891/ccog1831.2015] - DOI - PubMed
Ludington‐Hoe 2005 {published data only}
    1. Ludington‐Hoe SM, Hosseini R, Torowicz DL. Skin‐to‐skin contact (kangaroo care) analgesia for preterm infant heel stick. AACN Clinical Issues: Advanced Practice in Acute and Critical Care 2005;16(3):373‐87. - PMC - PubMed
Mosayebi 2014 {published data only}
    1. Mosayebi Z, Javidpour M, Rahmati M, Hagani H, Movahedia AH. The effect of kangaroo mother care on pain from heel lance in preterm newborns admitted to neonatal intensive care unit: A crossover randomized clinical trial. Journal of Comprehensive Pediatrics 2014;5(4):1‐6.
Nanavati 2013 {published data only}
    1. Nanavati RN, Balan R, Kabra NS. Effect of kangaroo mother care vs expressed breast milk administration on pain associated with removal of adhesive tape in very low birth weight neonates: a randomized controlled trial. Indian Pediatrics 2013;50(11):1011‐5. [PUBMED: 23798626] - PubMed
Nimbalkar 2013 {published and unpublished data}
    1. Nimbalkar SM, Chaudhary NS, Gadhavi KV, Phatak A. Kangaroo mother care in reducing pain in preterm neonates on heel prick. Indian Journal of Pediatrics 2013;80(1):6‐10. - PubMed
Okan 2010 {published data only (unpublished sought but not used)}
    1. Okan F, Ozdil A, Bulbul A, Yapici Z, Nuhoglu A. Analgesic effects of skin‐to‐skin contact and breastfeeding in procedural pain in healthy term neonates. Annals of Tropical Paediatrics 2010;30(2):119‐28. - PubMed
Saeidi 2011 {published data only}
    1. Saeidi R, Asnaashari Z, Amirnejad M, Esmaeili H, Robatsangi MG. Use of "Kangaroo Care" to alleviate the intensity of vaccination pain in newborns. Iranian Journal of Pediatrics March 2011;21(1):99‐102. - PMC - PubMed
Sajedi 2007 {published data only}
    1. Sajedi F, Kashaninia Z, Rahgozar M, Noghabi FA. The effect of Kangaroo Care on physiologic responses to pain of an intramuscular injection in neonates. Iranian Journal of Pediatrics 2007;17(4):339‐44. - PubMed

References to studies excluded from this review

Abdel‐Razek 2009 {published data only}
    1. Abdel‐Razek A, Az El‐Dein N. Effect of breast‐feeding on pain relief during infant immunization injections. International Journal of Nursing Practice 2009;15(2):99‐104. - PubMed
Arditi 2006 {published data only}
    1. Arditi H, Feldman R, Eidelman AI. Effects of human contact and vagal regulation on pain reactivity and visual attention in newborns. Developmental Psychobiology 2006;48(7):561‐73. - PubMed
Axelin 2009 {published data only}
    1. Axelin A, Salanterä S, Kirjavainen J, Lehtonen L. Oral glucose and parental holding preferable to opioid in pain management in preterm infants. The Clinical Journal of Pain 2009;25(2):138‐45. - PubMed
Bellieni 2002 {published data only}
    1. Bellieni CV, Bagnoli F, Perrone S, Nenci A, Cordelli DM, Fusi M, et al. Effect of multisensory stimulation on analgesia in term neonates: a randomized controlled trial. Pediatric Research 2002;51(4):460‐3. - PubMed
Bellieni 2007 {published data only}
    1. Bellieni CV, Cordelli DM, Marchi S, Ceccarelli S, Perrone S, Maffei M, et al. Sensorial saturation for neonatal analgesia. The Clinical Journal of Pain 2007;23(3):219‐21. - PubMed
Campbell‐Yeo 2012 {published data only}
    1. Campbell‐Yeo ML, Johnston CC, Joseph KS, Feeley NL, Chambers CT, Barrington KJ. Cobedding and recovery time after heel lance in preterm twins: results of a randomized trial. Pediatrics 2012;130(3):500‐6. - PubMed
Campbell‐Yeo 2013 {published data only}
    1. Campbell‐Yeo M, Johnston C, Benoit B, Latimer M, Vincer M, Watker CD, et al. Trial of repeated analgesia with Kangaroo Mother Care (TRAKC Trial). BMC Pediatrics 2013;13:182. [PUBMED: 2428400] - PMC - PubMed
Castral 2015 {published data only}
    1. Castral TC, Warnock F, Dos Santos CB, Dare MF, Moreira AC, Antonini SR, et al. Maternal mood and concordant maternal and infant salivary cortisol during heel lance while in kangaroo care. European Journal of Pain 2015;19(3):429‐38. - PubMed
Chidambaram 2014 {published data only}
    1. Chidambaram AG, Manjula S, Adhisivam B, Bhat BV. Effect of Kangaroo mother care in reducing pain due to heel prick among preterm neonates: a crossover trial. The Journal of Maternal Fetal & Neonatal Medicine 2014;27(5):488‐90. [PUBMED: 23796239] - PubMed
Choudhary 2015 {published data only}
    1. Choudhary M, Dogiyal H, Sharma D, Datt Gupta B, Madabhavi I, Choudhary JS, et al. To study the effect of kangaroo mother care on pain response in preterm neonates and to determine the behavioural and physiological responses to painful stimuli in preterm neonates: A study from western Rajasthan. The Journal of Maternal‐Fetal & Neonatal Medicine 2016;29(5):826‐31. - PubMed
Erlandsson 2007 {published data only}
    1. Erlandsson K, Dsilna A, Fagerberg I, Christensson K. Skin‐to‐skin care with the father after cesarean birth and its effect on newborn crying and prefeeding behavior. Birth: Issues in Perinatal Care 2007;34(2):105‐14. - PubMed
Ferber 2008 {published data only}
    1. Ferber SG, Makhoul IR. Neurobehavioural assessment of skin‐to‐skin effects on reaction to pain in preterm infants: a randomized, controlled within‐subject trial. Acta Pædiatrica 2008;97(2):171‐6. - PubMed
Gabriel 2010 {published data only}
    1. Marín Gabriel MA, Llana Martin I, López Escobar A, Fernández Villalba E, Romero Blanco I, Touza Pol P. Randomized controlled trial of early skin‐to‐skin contact; effects on the mother and the newborn. Acta Paediatrica 2010;99(11):1630‐4. - PubMed
Gazzolo 2000 {published data only}
    1. Gazzolo D, Masetti P, Meli M. Kangaroo care improves post‐extubation cardiorespiratory parameters in infants after open heart surgery. Acta Paediatrica 2000;89(6):728‐9. - PubMed
Johnston 2007 {published data only}
    1. Johnston CC, Filion F, Nuyt AM. Recorded maternal voice for preterm neonates undergoing heel lance. Advances in Neonatal Care 2007;7(5):258‐66. - PubMed
Kashaninia 2008 {published data only}
    1. Kashaninia Z, Sajedi F, Rahgozar M, Noghabi FA. The effect of Kangaroo Care on behavioral responses to pain of an intramuscular injection in neonates. Journal for Specialists in Pediatriac Nursing 2008;13(4):275‐80. - PubMed
Lyngstad 2014 {published data only}
    1. Lyngstad LT, Tandberg BS, Storm H, Ekeberg BL, Moen A. Does skin‐to‐skin contact reduce stress during diaper change in preterm infants?. Early Human Development 2014;90(4):169‐72. [PUBMED: 24548816] - PubMed
Miles 2006 {published data only}
    1. Miles R, Cowan F, Glover V, Stevenson J, Modi N. A controlled trial of skin‐to‐skin contact in extremely preterm infants. Early Human Development 2006;82(7):447‐55. - PubMed
Mitchell 2013 {published data only}
    1. Mitchell AJ, Yates CC, Williams DK, Chang JY, Hall RW. Does daily kangaroo care provide sustained pain and stress relief in preterm infants?. Journal of Neonatal‐Perinatal Medicine 2013;6(1):45‐52. - PMC - PubMed
Mooncey 1997 {published data only}
    1. Mooncey S, Giannakoulopoulos X, Glover V, Acolet D, Modi N. The effect of mother‐infant skin‐to‐skin contact on plasma cortisol and beta‐endorphin concentrations in preterm newborns. Infant Behavior & Development 1997;20(4):553‐7.
Mörelius 2005 {published data only}
    1. Mörelius E, Theodorsson E, Nelson N. Salivary cortisol and mood and pain profiles during skin‐to‐skin care for an unselected group of mothers and infants in neonatal intensive care. Pediatrics 2005;116(5):1105‐13. - PubMed
Obeidat 2015 {published data only}
    1. Obeidat HM, Shuriquie MA. Effect of breast‐feeding and maternal holding in relieving painful responses in full‐term neonates. Journal of Perinatal & Neonatal Nursing 2015;29(3):248‐54. - PubMed
Olsson 2015 {published data only}
    1. Olsson E, Ahlsen G, Eriksson M. Skin‐to‐skin contact reduces near‐infrared spectroscopy pain responses in premature infants during blood sampling. Acta Paediatrica 2015;105(4):376‐80. - PubMed
Reis 2003 {published data only}
    1. Reis EC, Roth EK, Syphan JL, Tarbell SE, Holubkov R. Effective pain reduction for multiple immunization injections in young infants. Archives of Pediatrics & Adolescent Medicine 2003;157(11):1115‐20. - PubMed
Schlez 2011 {published data only}
    1. Schlez A, Litmanovitz I, Bauer S, Dolfin T, Regev R, Arnon S. Combining kangaroo care and live harp music therapy in the neonatal intensive care unit setting. Israel Medical Association Journal 2011;13(6):254‐8. - PubMed
Silva 2004 {published data only}
    1. Silva LM, Clapis MJ. Understanding maternal experiences during her first contact with her child on the birth's room [Compreendendo a vivência materna no primeiro contato com seu filho na sala de parto]. Acta Paulista de Enfermagem 2004;17(3):286‐91.
Uga 2008 {published data only}
    1. Uga E, Candriella M, Perino A, Alloni V, Angilella G, Trada M, et al. Heel lance in newborn during breastfeeding: an evaluation of analgesic effect of this procedure. Italian Journal of Pediatrics 2008;34(1):3. - PMC - PubMed
Vivancos 2010 {published data only}
    1. Zavanella Vivancos RB, Moraes Leite A, Silvan Scochi CG, dos Santos CB. The skin to skin contact at birth and newborn crying during vaccination against Hepatitis B [O contato pele a pele ao nascimento e o choro de recém‐nascidos durante vacinação contra Hepatite B]. Acta Paulista de Enfermagem 2010;23(4):461‐5.

References to studies awaiting assessment

Mahindre 2009 {published data only}
    1. Mahindre A. Kangaroo Mother Care (KMC) diminishes pain in preterm Infants. Acta Paediatrica 2009;98(s460):181‐2.

References to ongoing studies

IRCT2014120217972N4 {published and unpublished data}
    1. IRCT2014120217972N4. Paternal vs Maternal Kangaroo and routine care for pain relief in preterm neonates after heel lancet procedure. http://apps.who.int/trialsearch/Trial2.aspx?TrialID=IRCT2014120217972N4 (accessed 26 February 2016).
IRCT201505142639N16 {published and unpublished data}
    1. IRCT201505142639N16. Efficacy of kangaroo mother care, breastfeeding and swaddling on BCG vaccine pain score in neonates. http://apps.who.int/trialsearch/Trial2.aspx?TrialID=IRCT201505142639N16 (accessed 26 February 2016).
IRCT2015052914251N3 {published and unpublished data}
    1. IRCT2015052914251N3. Effect of neonate's massage and kangaroo mother care on neonates' pain. http://apps.who.int/trialsearch/Trial2.aspx?TrialID=IRCT2015052914251N3 (accessed 26 February 2016).

Additional references

Akman 2002
    1. Akman I, Ozek E, Bilgen H, Ozdogan T, Cebeci D. Sweet solutions and pacifiers for pain relief in newborn infants. The Journal of Pain 2002;3(3):199‐202. - PubMed
Anand 2004
    1. Anand KJ, Hall RW, Desai N, Shephard B, Bergqvist LL, Young TE, et al. NEOPAIN Trial Investigators Group. Effects of morphine analgesia in ventilated preterm neonates: primary outcomes from the NEOPAIN randomised trial. Lancet 2004;363(9422):1673‐82. - PubMed
Bauer 1998
    1. Bauer K, Pyper A, Sperling P, Uhrig C, Versmold H. Effects of gestational and postnatal age on body temperature, oxygen consumption, and activity during early skin‐to‐skin contact between preterm infants of 25‐30‐week gestation and their mothers. Pediatric Research 1998;44(2):247‐51. - PubMed
Benoit 2016
    1. Benoit B, Campbell‐Yeo M, Johnston C, Latimer M, Caddell K, Orr T. Staff nurse utilization of kangaroo care as an intervention for procedural pain in preterm infants. Advances in Neonatal Care 2016;16(3):229‐38. [In press] - PubMed
Bohnhorst 2001
    1. Bohnhorst B, Heyne T, Peter CS, Poets CF. Skin‐to‐skin (kangaroo) care, respiratory control, and thermoregulation. The Journal of Pediatrics 2001;138(2):193‐7. - PubMed
Boundy 2016
    1. Boundy EO, Dastjerdi R, Spiegelman D, Fawzi WW, Missmer SA, Lieberman E, et al. Kangaroo mother care and neonatal outcomes: a meta‐analysis. Pediatrics 2016;137(1). - PMC - PubMed
Boyle 2004
    1. Boyle EM, McIntosh N. Pain and compassion in the neonatal unit ‐‐ a neonatologist's view. Neuro Endocrinology Letters 2004;25 Suppl 1:49‐55. - PubMed
Brummelte 2012
    1. Brummelte S, Grunau RE, Chau V, Poskitt KJ, Brant R, Vinall J, et al. Procedural pain and brain development in premature newborns. Annals of Neurology 2012;71(3):385‐96. - PMC - PubMed
Campbell‐Yeo 2008
    1. Campbell‐Yeo M, Johnston CC, Filion F, McNaughton K. A comparison of nurse and mother attitudes regarding maternal skin‐to‐skin care as a pain relieving strategy during heel lance for preterm neonates. 1st European Conference on the Kangaroo Mother Care Proceedings 2008.
Campbell‐Yeo 2015
    1. Campbell‐Yeo ML, Disher TC, Benoit BL, Johnston CC. Understanding kangaroo care and its benefits to preterm infants. Pediatric Health, Medicine and Therapeutics 2015;2015(6):15‐32. - PMC - PubMed
Campos 1994
    1. Campos RG. Rocking and pacifiers: two comforting interventions for heelstick pain. Research in Nursing and Health 1994;17(5):321‐31. - PubMed
Carbajal 1997
    1. Carbajal R, Paupe A, Hoenn E, Lenclen R, Olivier‐Martin M. APN: evaluation behavioral scale of acute pain in newborn infants [DAN:une échelle comportementale d’évaluation de la douleur aiguë du nouveau‐né]. Archives de Pediatrie 1997;4(7):623‐8. - PubMed
Carbajal 2002
    1. Carbajal R, Lenclen R, Gajdos V, Jugie M, Paupe A. Crossover trial of analgesic efficacy of glucose and pacifier in very preterm neonates during subcutaneous injections. Pediatrics 2002;110 (2 Pt 1):389‐93. - PubMed
Carbajal 2005
    1. Carbajal R, Lenclen R, Jugie M, Paupe A, Barton BA, Anand KJ. Morphine does not provide adequate analgesia for acute procedural pain among preterm neonates. Pediatrics 2005;115(6):1494‐500. - PubMed
Carbajal 2008
    1. Carbajal R, Rousset A, Danan C, Coquery S, Nolent P, Ducrocq S, et al. Epidemiology and treatment of painful procedures in neonates in intensive care units. JAMA 2008;300(1):60‐70. - PubMed
Carfoot 2003
    1. Carfoot S, Williamson PR, Dickson R. A systematic review of randomised controlled trials evaluating the effect of mother/baby skin‐to‐skin care on successful breast feeding. Midwifery 2003;19(2):148‐55. - PubMed
Charpak 2005
    1. Charpak N, Ruiz JG, Zupan J, Cattaneo A, Figueroa Z, Tessier R, et al. Kangaroo mother care: 25 years after. Acta Paediatrica 2005;94(5):514‐22. - PubMed
Christensson 1992
    1. Christensson K, Siles C, Moreno L, Belaustequi A, Fuente P, Lagercrantz H, et al. Temperature, metabolic adaptation and crying in healthy full‐term newborns cared for skin‐to‐skin or in a cot. Acta Paediatrica 1992;81(6‐7):488‐93. - PubMed
Chwo 2002
    1. Chwo MJ, Anderson GC, Good M, Dowling DA, Shiau SH, Chu DM. A randomized controlled trial of early kangaroo care for preterm infants: effects on temperature, weight, behavior, and acuity. Journal of Nursing Research 2002;10(2):129‐42. - PubMed
Cignacco 2007
    1. Cignacco E, Hamers JP, Stoffel L, Lingen RA, Gessler P, McDougall J, et al. The efficacy of non‐pharmacological interventions in the management of procedural pain in preterm and term neonates. A systematic literature review. European Journal of Pain 2007;11(2):139‐52. - PubMed
Conde‐Agudelo 2014
    1. Conde‐Agudelo A, Díaz‐Rossello JL. Kangaroo mother care to reduce morbidity and mortality in low birthweight infants. Cochrane Database of Systematic Reviews 2014, Issue 4. [DOI: 10.1002/14651858.CD002771.pub3] - DOI - PubMed
Corff 1995
    1. Corff KE, Seideman R, Venkataraman PS, Lutes L, Yates B. Facilitated tucking: a nonpharmacologic comfort measure for pain in preterm neonates. Journal of Obstetric, Gynecologic, and Neonatal Nursing 1995;24(2):143‐7. - PubMed
Craig 1984
    1. Craig KD, McMahon RJ, Morison JD, Zaskow C. Developmental changes in infant pain expression during immunization injections. Social Science and Medicine 1984;19(12):1331‐7. - PubMed
Cruz 2016
    1. Cruz MD, Fernandes AM, Oliveira CR. Epidemiology of painful procedures performed in neonates: a systematic review of observational studies. European Journal of Pain (London, England) 2016;20(4):489‐98. - PubMed
Cuzzolin 2001
    1. Cuzzolin L, Dal Cerè M, Fanos V. NSAID‐induced nephrotoxicity from the fetus to the child. Drug Safety 2001;24(1):9‐18. - PubMed
de Leeuw 1991
    1. Leeuw R, Collin EM, Dunnebier EA, Mirmiran M. Physiological effects of kangaroo care in very small preterm infants. Biology of the Neonate 1991;59(3):149‐55. - PubMed
Elbourne 2002
    1. Elbourne DR, Altman DG, Higgins JP, Curtin F, Worthington HV, Vail A. Meta‐analyses involving cross‐over trials: methodological issues. International Journal of Epidemiology 2002;31(1):140‐9. - PubMed
Erez 1996
    1. Erez A, Bloom MC, Wells MT. Using random rather than fixed effects models in meta‐analysis: implications for situational specificity and validity generalization. Personnel Psychology 1996;49(2):275‐306.
Feldman 2002
    1. Feldman R, Weller A, Sirota L, Eidelman AI. Skin‐to‐skin contact (Kangaroo care) promotes self‐regulation in premature infants: sleep‐wake cyclicity, arousal modulation, and sustained exploration. Developmental Psychology 2002;38(2):194‐207. - PubMed
Feldman 2003
    1. Feldman R, Eidelman AI. Skin‐to‐skin contact (Kangaroo care) accelerates autonomic and neurobehavioural maturation in preterm infants. Developmental Medicine and Child Neurology 2003;45(4):274‐81. - PubMed
Ferber 2004
    1. Ferber SG, Makhoul IR. The effect of skin‐to‐skin contact (kangaroo care) shortly after birth on the neurobehavioral responses of the term newborn: a randomized, controlled trial. Pediatrics 2004;113(4):858‐65. - PubMed
Field 2003
    1. Field AP. The problem in using fixed‐effects models of meta‐analysis on real‐world data. Understanding Statistics 2003; Vol. 2, issue 2:105‐24.
Franck 2001
    1. Franck LS, Scurr K, Couture S. Parent views of infant pain and pain management in the neonatal intensive care unit. Newborn and Infant Nursing Reviews 2001;1(2):106‐13.
Franck 2002
    1. Franck LS, Bernal H, Gale G. Infant holding policies and practices in neonatal units. Neonatal Network ‐ The Journal of Neonatal Nursing 2002;21(2):13‐20. - PubMed
Gibbins 2008
    1. Gibbins S, Stevens B, Beyene J, Chan PC, Bagg M, Asztalos E. Pain behaviours in extremely low gestational age infants. Early Human Development 2008;84(7):451‐8. - PubMed
GRADEpro 2014 [Computer program]
    1. McMaster University. GRADEpro. McMaster University, 2014.
Grunau 2007a
    1. Grunau RE, Haley DW, Whitfield MF, Weinberg J, Yu W, Thiessen P. Altered basal cortisol levels at 3, 6, 8 and 18 months in infants born at extremely low gestational age. The Journal of Pediatrics 2007;150(2):151‐6. - PMC - PubMed
Grunau 2007b
    1. Grunau RE, Tu MT. Long‐term consequences of pain in human neonates. In: Anand KJ, Stevens BJ, McGrath PJ editor(s). Pain in Neonates and Infants. 3rd Edition. Philadelphia: Elsevier, 2007:55‐76.
Hedges 1998
    1. Hedges LV, Vevea JL. Fixed‐ and random‐effects models in meta‐analysis. Psychological Methods 1998; Vol. 3, issue 4:486‐504.
Higgins 2011
    1. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org.
Holsti 2007
    1. Holsti L, Grunau RE. Initial validation of the behavioral indicators of infant pain (BIIP). Pain 2007;132(3):264‐72. - PMC - PubMed
Hummel 2008
    1. Hummel P, Puchalski M, Creech SD, Weiss MG. Clinical reliability and validity of the N‐PASS: neonatal pain, agitation and sedation scale with prolonged pain. Journal of Perinatology 2008;28(1):55‐60. - PubMed
Hummel 2010
    1. Hummel P, Lawlor‐Klean P, Weiss MG. Validity and reliability of the N‐PASS assessment tool with acute pain. Journal of Perinatology 2010;30(7):474‐8. - PubMed
Hunt 2008
    1. Hunt F. The importance of kangaroo care on infant oxygen saturation levels and bonding. Journal of Neonatal Nursing 2008;14(2):47‐51.
Ibe 2004
    1. Ibe OE, Austin T, Sullivan K, Fabanwo O, Disu E, Costello AM. A comparison of kangaroo mother care and conventional incubator care for thermal regulation of infants < 2000 g in Nigeria using continuous ambulatory temperature monitoring. Annals of Tropical Paediatrics 2004;24(3):245‐51. - PubMed
Johnson 2006
    1. Johnson AN. The relationship of kangaroo holding to maternal breast milk. Journal of Pediatric Nursing 2006;21(2):137‐8.
Johnston 1993
    1. Johnston CC, Stevens B, Craig KD, Grunau RV. Developmental changes in pain expression in premature, full‐term, two‐ and four‐month‐old infants. Pain 1993;52(2):201‐8. - PubMed
Johnston 1996
    1. Johnston CC, Stevens BJ. Experience in a neonatal intensive care unit affects pain response. Pediatrics 1996;98(5):925‐30. - PubMed
Johnston 1997
    1. Johnston CC, Collinge JM, Henderson SJ, Anand KJ. A cross‐sectional survey of pain and pharmacological analgesia in Canadian neonatal intensive care units. The Clinical Journal of Pain 1997;13(4):308‐12. - PubMed
Johnston 2002
    1. Johnston CC, Filion F, Snider L, Majnemer A, Limperopoulos C, Walker CD, et al. Routine sucrose analgesia during the first week of life in neonates younger than 31 weeks' postconceptional age. Pediatrics 2002;110(3):523‐8. - PubMed
Johnston 2007a
    1. Johnston CC, Filion F, Snider L, Limperopoulos C, Majnemer A, Pelausa E, et al. How much sucrose is too much sucrose?. Pediatrics 2007;119(1):226. - PubMed
Johnston 2007b
    1. Johnston CC, Filion F, Nuyt AM. Recorded maternal voice for preterm neonates undergoing heel lance. Advances in Neonatal Care 2007;7(5):258‐66. - PubMed
Johnston 2011b
    1. Johnston C, Barrington KJ, Taddio A, Carbajal R, Filion F. Pain in Canadian NICUs: have we improved over the past 12 years?. The Clinical Journal of Pain 2011;27(3):225‐32. - PubMed
Johnston, 2014
    1. Johnston C, Campbell‐Yeo M, Fernandes A, Inglis D, Streiner D, Zee R. Skin‐to‐skin care for procedural pain in neonates. Cochrane Database of Systematic Reviews 2014, Issue 1. [DOI: 10.1002/14651858.CD008435.pub2] - DOI - PubMed
Ko 1998
    1. Ko Y. Parental stress in the Neonatal Intensive Care Unit (NICU) [Chinese]. Nursing Research (China) 1998;6(5):427‐35.
Lagercrantz 1992
    1. Lagercrantz H. What does the preterm infant breathe for? Controversies on apnea of prematurity. Acta Paediatrica 1992;81(10):733‐6. - PubMed
Larsson 1996
    1. Larsson BA, Norman M, Bjerring P, Egekvist H, Lagercrantz H, Olsson GL. Regional variations in skin perfusion and skin thickness may contribute to varying efficacy of topical, local anaesthetics in neonates. Paediatric Anaesthesia 1996;6(2):107‐10. - PubMed
Lawrence 1993
    1. Lawrence J, Alcock D, McGrath P, Kay J, MacMurray SB, Dulberg C. The development of a tool to assess neonatal pain. Neonatal Network 1993;12(6):59‐66. - PubMed
Lefrak 2006
    1. Lefrak L, Burch K, Caravantes R, Knoerlein K, DeNolf N, Duncan J, et al. Sucrose analgesia: identifying potentially better practices. Pediatrics 2006;118 Suppl 2:S197‐202. - PubMed
Ludington‐Hoe 1992
    1. Ludington‐Hoe SM, Hashemi MS, Argote LA, Medellin G, Rey H. Selected physiologic measures and behavior during paternal skin contact with Colombian preterm infants. Journal of Developmental Physiology 1992;18(5):223‐32. - PubMed
Ludington‐Hoe 1996
    1. Ludington‐Hoe SM, Swinth JY. Developmental aspects of kangaroo care. Journal of Obstetric, Gynecologic, and Neonatal Nursing 1996;25(8):691‐703. - PubMed
Ludington‐Hoe 1999
    1. Ludington‐Hoe SM, Anderson GC, Simpson S, Hollingsead A, Argote LA, Rey H. Birth‐related fatigue in 34‐36‐week preterm neonates: rapid recovery with very early kangaroo (skin‐to‐skin) care. Journal of Obstetric, Gynecologic, and Neonatal Nursing 1999;28(1):94‐103. - PubMed
Ludington‐Hoe 2004
    1. Ludington‐Hoe SM, Anderson GC, Swinth JY, Thompson C, Hadeed AJ. Randomized controlled trial of kangaroo care: cardiorespiratory and thermal effects on healthy preterm infants. Neonatal Network ‐ The Journal of Neonatal Nursing 2004;23(3):39‐48. - PubMed
Marsh 1997
    1. Marsh DF, Hatch DJ, Fitzgerald M. Opioid systems and the newborn. British Journal of Anaesthesia 1997;79(6):787‐95. - PubMed
McCain 2005
    1. McCain GC, Ludington‐Hoe SM, Swinth JY, Hadeed AJ. Heart rate variability responses of a preterm infant to kangaroo care. Journal of Obstetric, Gynecologic, and Neonatal Nursing 2005;34(6):689‐94. - PMC - PubMed
Michelsson 1996
    1. Michelsson K, Christensson K, Rothganger H, Winberg J. Crying in separated and non‐separated newborns: sound spectrographic analysis. Acta Paediatrica 1996;85(4):471‐5. - PubMed
Miles 1989
    1. Miles MS, Carter MC, Riddle I, Hennessey J, Eberly TW. The pediatric intensive care unit environment as a source of stress for parents. Maternal‐Child Nursing Journal 1989;18(3):199‐206. - PubMed
Miles 1992
    1. Miles MS, Funk SG, Kasper MA. The stress response of mothers and fathers of preterm infants. Research in Nursing and Health 1992;15(4):261‐9. - PubMed
Moehn 1996
    1. Moehn DG, Rossetti L. The effects of neonatal intensive care on parental emotions and attachment. Infant‐Toddler Intervention: The Transdisciplinary Journal 1996;6(3):229‐46.
Moore 2012
    1. Moore ER, Anderson GC, Bergman N, Dowswell T. Early skin‐to‐skin contact for mothers and their healthy newborn infants. Cochrane Database of Systematic Reviews 2012, Issue 5. [DOI: 10.1002/14651858.CD003519.pub3] - DOI - PMC - PubMed
Oberlander 2000
    1. Oberlander TF, Grunau RE, Whitfield MF, Fitzgerald C, Pitfield S, Saul JP. Biobehavioral pain responses in former extremely low birth weight infants at four months' corrected age. Pediatrics 2000;105(1):e6. - PubMed
Overton 1998
    1. Overton RC. A comparison of fixed‐effects and mixed (random‐effects) models for meta‐analysis tests of moderator variable effects. Psychological Methods 1998;3(3):354‐79.
Pillai Riddell 2015
    1. Pillai Riddell RR, Racine NM, Gennis HG, Turcotte K, Uman LS, Horton RE. Non‐pharmacological management of infant and young child procedural pain. Cochrane Database of Systematic Reviews 2015, Issue 12. [DOI: 10.1002/14651858.CD006275.pub3] - DOI - PMC - PubMed
Pillai Riddell 2016
    1. Pillai Riddell R, Fitzgerald M, Slater R, Steens B, Johnston C, Campbell‐Yeo M. Using only behaviours to assess infant pain: a painful compromise?. Pain 2016;157(8):1579‐80. - PubMed
Schünemann 2013
    1. Schünemann H, Brożek J, Guyatt G, Oxman A, editors. GRADE Working Group. GRADE handbook for grading quality of evidence and strength of recommendations. Available from www.guidelinedevelopment.org/handbook Updated October 2013.
Shields‐Poë 1997
    1. Shields‐Poë D, Pinelli J. Variables associated with parental stress in neonatal intensive care units. Neonatal Network ‐ Journal of Neonatal Nursing 1997;16(1):29‐37. - PubMed
Simons 2001
    1. Simons J, Franck L, Roberson E. Parent involvement in children's pain care: view of parents and nurses. Journal of Advanced Nursing 2001;36(4):591‐9. - PubMed
Simons 2003
    1. Simons SH, Dijk M, Anand KS, Roofthooft D, Lingen RA, Tibboel D. Do we still hurt newborn babies? A prospective study of procedural pain and analgesia in neonates. Archives of Pediatrics & Adolescent Medicine 2003;157(11):1058‐64. - PubMed
Stevens 1996
    1. Stevens BJ, Johnston CC, Petryshen P, Taddio A. Premature infant pain profile: Development and validation. The Clinical Journal of Pain 1996;12(1):13‐22. - PubMed
Stevens 1999a
    1. Stevens B, Johnston C, Taddio A, Jack A, Narciso J, Stremler R, et al. Management of pain from heel lance with lidocaine‐prilocaine (EMLA) cream: is it safe and efficacious in preterm infants?. Journal of Developmental & Behavioral Pediatrics 1999;20(4):216‐21. - PubMed
Stevens 1999b
    1. Stevens BJ, Johnston C, Franck L, Petryshen P, Jack A, Foster R. The efficacy of developmentally sensitive interventions and sucrose for relieving procedural pain in very low birth weight neonates. Nursing Research 1999;48(1):35‐43. - PubMed
Stevens 2003
    1. Stevens B, McGrath P, Gibbins S, Beyene J, Breau L, Camfield C, et al. Procedural pain in newborns at risk for neurologic impairment. Pain 2003;105(1‐2):27‐35. - PubMed
Stevens 2007
    1. Stevens BJ, Pillai Riddell RR, Oberlander TE, Gibbins S. Assessment of pain in neonates and infants. In: Anand KJ, Stevens BJ, McGrath PJ editor(s). Pain in Neonates and Infants. 3rd Edition. Philadelphia: Elsevier, 2007:67‐90.
Stevens 2010
    1. Stevens B, Johnston C, Taddio A, Gibbins S, Yamada J. The premature infant pain profile: evaluation 13 years after development. Clinical Journal of Pain 2010;26(9):813‐30. - PubMed
Stevens 2013
    1. Stevens B, Yamada J, Lee GY, Ohlsson A. Sucrose for analgesia in newborn infants undergoing painful procedures. Cochrane Database of Systematic Reviews 2013, Issue 1. [DOI: 10.1002/14651858.CD001069.pub4] - DOI - PubMed
van Dijk 2000
    1. Dijk M, Boer JB, Koot HM, Tibboel D, Passchier J, Duivenvoorden HJ. The reliability and validity of the COMFORT scale as a postoperative pain instrument in 0 to 3‐year‐old infants. Pain 2000;84(2‐3):367‐77. - PubMed
Vinall 2014
    1. Vinall J, Miller SP, Bjornson BH, Fitzpatrick KP, Poskitt KJ, Brant R, et al. Invasive procedures in preterm children: brain and cognitive development at school age. Pediatrics 2014;133(3):412‐21. - PMC - PubMed
Warnock 2010
    1. Warnock FF, Castral TC, Brant R, Sekilian M, Leite AM, Owens Sde L, et al. Brief Report: Maternal kangaroo care for neonatal pain relief: A systematic narrative review. Journal of Pediatric Psychology 2010;35(9):975‐84. - PubMed
Wereszczak 1997
    1. Wereszczak J, Miles MS, Holditch‐Davis D. Maternal recall of the neonatal intensive care unit. Neonatal Network ‐ Journal of Neonatal Nursing 1997;16(4):33‐40. - PubMed
Whitelaw 1985
    1. Whitelaw A, Sleath K. Myth of the marsupial mother: Home care of the very low birth weight babies in Bogota, Colombia. Lancet 1985;1(8439):1206‐8. - PubMed
Yamanda 2008
    1. Yamanda J, Stinson J, Lamba J, Dickson A, McGrath PJ, Stevens B. A review of systematic reviews on pain interventions in hospitalized infants. Pain Research & Management 2008;13(5):413‐20. - PMC - PubMed
Youngblut 1992
    1. Youngblut JM, Shiao SY. Characteristics of a child's critical illness and parents' reactions: preliminary report of a pilot study. American Journal of Critical Care. 1992;1(3):80‐4. - PubMed

References to other published versions of this review

Johnston 2014
    1. Johnston C, Campbell‐Yeo M, Fernandes A, Inglis D, Streiner D, Zee R. Skin‐to‐skin care for procedural pain in neonates. Cochrane Database of Systematic Reviews 2014, Issue 1. [DOI: 10.1002/14651858.CD008435.pub2] - DOI - PubMed

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