Vol. 2, Issue 1, Part A (2025)

Background: Effective pain management in neonates is essential to prevent both immediate physiological instability and potential long-term neurodevelopmental consequences. Non-pharmacological interventions such as oral sucrose, skin-to-skin contact, and non-nutritive sucking have emerged as safe and feasible strategies for routine procedural pain relief. Objective: To compare the effectiveness of three non-pharmacological interventions—oral sucrose 24%, skin-to-skin contact, and non-nutritive sucking in reducing procedural pain among neonates undergoing heel prick procedures. Methods: A randomized controlled trial was conducted on 120 neonates admitted to a tertiary NICU, allocated into four groups: oral sucrose, skin-to-skin contact, non-nutritive sucking, and control. Pain intensity was assessed using the Premature Infant Pain Profile (PIPP) score, while physiological responses were evaluated through heart rate and oxygen saturation measurements. Statistical analysis included one-way ANOVA and Bonferroni-adjusted t-tests to determine between-group differences. Results: Both oral sucrose and skin-to-skin contact significantly reduced pain intensity compared to control, with mean PIPP scores of 6. 00±2. 03 and 6. 99±1. 84, respectively, versus 11. 93±2. 52 in the control group. Non-nutritive sucking produced a moderate but significant reduction (8. 30±2. 57). Physiological stress responses, including heart rate elevation and oxygen desaturation, were also markedly lower in the intervention groups. Severe pain episodes (PIPP ≥ 12) were nearly eliminated in the oral sucrose and skin-to-skin groups (0%) compared to control (46. 7%). Statistical analysis revealed large effect sizes for primary outcomes, supporting the clinical significance of the findings. Conclusion: Oral sucrose and skin-to-skin contact are highly effective, safe, and easily implementable interventions for neonatal procedural pain management, while non-nutritive sucking serves as a valuable adjunct. Integrating these strategies into routine neonatal care protocols can enhance pain control, improve physiological stability, and support developmental outcomes. Standardizing these evidence-based interventions and training healthcare personnel can ensure consistent, high-quality pain management across NICUs.