A cross-sectional examination of the relationships between caregiver proximal soothing and infant pain over the first year of life

Abstract

Although previous research has examined the relationships between caregiver proximal soothing and infant pain, there is a paucity of work taking infant age into account, despite the steep developmental trajectory that occurs across the infancy period. Moreover, no studies have differentially examined the relationships between caregiver proximal soothing and initial infant pain reactivity and pain regulation. This study examined how much variance in pain reactivity and pain regulation was accounted for by caregiver proximal soothing at 4 routine immunizations (2, 4, 6, and 12 months) across the first year of life, controlling for preneedle distress. One latent growth model was replicated at each of the 4 infant ages, using a sample of 760 caregiver-infant dyads followed longitudinally. Controlling for preneedle infant distress, caregiver proximal soothing accounted for little to no variance in infant pain reactivity or regulation at all 4 ages. Preneedle distress and pain reactivity accounted for the largest amount of variance in pain regulation, with this increasing after 2 months. It was concluded that within each immunization appointment across the first year of life, earlier infant pain behaviour is a stronger predictor of subsequent infant pain behaviour than caregiver proximal soothing. Given the longer-term benefits that have been demonstrated for proximal soothing during distressing contexts, caregivers are still encouraged to use proximal soothing during infant immunizations.

Preschool children's coping responses and outcomes in the vaccination context: child and caregiver transactional and longitudinal relationships

“…A similar pattern was found for caregiver coping-and distress-promoting behaviors in study 2. In line with previous research, 1,17,25 children's pain strongly predicts subsequent children's pain prospectively. An integration of these findings with a focus on clinical implications will be presented in our conclusion.…”

“…In terms of entering child distress behaviors from the directly preceding time epoch into the models, this choice was made because a critical assumption in creating the path models was that young children's pain responding during painful procedures has been established to predict subsequent pain responding to that procedure. 1,17,25 Thus, all path models included a predictor variable of preschooler's pain-related distress from the closest time point preceding each dependent variable of interest. To parallel this, the same was done with both coping-promoting and distresspromoting caregiver variables.…”

“…Finally, a requirement of structural equation modeling is that, regardless of relationships of interest in one's study, if a meaningful relationship exists between 2 variables, this relationship must be accounted for in the analysis to ensure model fit. Thus, the various significant relationships among the variables from the 12-month vaccination were accounted for in the models but because they have been previously examined and reported, 4,17,36,38 they were not of interest and will not be described in the text below. Table 4 presents all standardized and unstandardized parameter estimates.…”

Are Parents Really That Important To Managing Vaccination Pain During Infancy?

“…The first infant waves of the cohort were naturalistic observations of infants and their parents at their 2, 4, 6 and 12 month immunizations. Among the findings from this longitudinal study, it was found that commonly occurring parent pain management strategies from the literature (e.g., rocking, proximal soothing, verbal reassurance) accounted for statistically significant yet minimal amounts of variance in infant pain responding (ranging from 2 to 13%) [5][6][7]. It was shown that as children aged over the first year of life, parent strategies accounted for increasing variance in observed childhood pain-related distress.…”

Infant Clinical Pain Assessment: Core Behavioral Cues

“…were included in the current analyses, as they have been shown to have the strongest relationship with infant pain-related distress [6,22]. The three caregiver behaviours were coded as present (1) or absent (0) for five-second epochs during the following three 60-second periods: (1) the oneminute period prior to the needle, (2) the one-minute period following the last needle, and (3) the two-minute period following the last needle.…”