The impact of infant positioning on pain and early neonatal morbidities

Purpose: To investigate whether appropriate positioning, assessed using the Infant Positioning Assessment Tool (IPAT), is associated with lower pain scores and reduced incidence of early neonatal morbidities in the first week of life in premature infants. Methods: This retrospective observational study was conducted at a single center. The pre-implementation (non IPAT) group was assessed using the NPASS (Neonatal Pain, Agitation, and Sedation Scale) alone, whereas the post-implementation (IPAT) group was evaluated using both the NPASS and the IPAT. Results: The IPAT group consisted of 77 infants, and the non-IPAT group consisted of 40 infants. The mean gestational age and weight of the cases were 29.9 ± 1.2 weeks and 1350 ± 234 g, respectively. Pain scores increased in infants with intraventricular hemorrhage (IVH) (days 3 and 7) and necrotizing enterocolitis (NEC) (days 4 and 5), but decreased with IPAT use on days 5–7. IPAT scores showed a moderate negative correlation with IVH on days 1 and 6, and a strong negative correlation with NEC on day 7. Conclusion: Higher positioning quality is associated with lower pain scores and potentially fewer early morbid ities in preterm infants during the first week of life. Optimal positioning using the IPAT will help establish nursing standards and increase awareness among primary caregivers.