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Postural support improves distress and pain during diaper change in preterm infants



To determine the effects of a postural support protocol on the physiological and behavioral stability of preterm infants while undergoing a diaper change.

Study Design:

Forty-seven newborns having a birth weight 2000 g and gestational age 35 weeks were included in this randomized, crossover clinical trial in a Neonatology Intensive Care Unit. The infants were observed as his or her own control and evaluated with and without the use of the proposed intervention, which was positioning the baby in a nest produced with rolled-up towels. During the observations, as control, the care model used by the unit was considered.


All babies displayed increased distress and pain scores during diaper changes. This was significantly less for babies nested compared with non-nested babies (P<0.0001).


Diaper change is a distressing procedure for preterm infants. Providing postural support during diaper changes reduces the signs of distress and pain.

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This work was financially supported by the Research Support Fund (FIPE) of the Hospital de Clínicas in Porto Alegre and by a CNPq Scholarship.

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Correspondence to T Comaru.

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The study was registered by no. 03279 in the Institutional Review Board IRB0000921.

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Comaru, T., Miura, E. Postural support improves distress and pain during diaper change in preterm infants. J Perinatol 29, 504–507 (2009).

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