Table 1 Treatment groups

Group 1

Standard care with glucose

The infant is placed on the examination table for the blood test. Standard care comprises facilitated tucking done by a nurse or the parent, 1–2 ml of oral glucose (300 mg/ml) given in fractioned doses from 2 min before the procedure and the opportunity to suck on a pacifier or on a parent’s or a nurse’s plastic gloved finger.

Group 2a

Parent-driven pain management with skin-to-skin contact

The parent will sit in an adjustable recliner chair during the procedure and the infant will be placed naked (except for a diaper and possibly a hat) on the parent’s bare chest 10 min before the venipuncture. The skin-to-skin contact will proceed during and a while after the procedure.

Group 2b

Parent-driven pain management with skin-to-skin contact and breastfeeding

The parent will sit in an adjustable recliner chair during the procedure and the infant will be placed naked (except for a diaper and possibly a hat) on the parent’s bare chest 10 min before the venipuncture. Breastfeeding starts about 2 min before the venipuncture and the blood test is performed when the infant is latched and sucking well.

Group 3

Parent-driven pain management with a combination of skin-to-skin contact, breastfeeding and live parental lullaby singing

The intervention in the combination group will follow the above described skin-to-skin and breastfeeding treatment descriptions. The parents are also instructed to hum a lullaby with their infant. The parent starts humming the lullaby when the infant is placed on the parent’s bare chest 10 min before the venipuncture and continues during and a while after the procedure. The humming should be performed in a simple, repetitive, soft and sedative mode in a low pitch, in consonant harmony, with a slow, steady and predictable pulse of 3/4 or 6/8 rhythm, maintaining a constant sound level between recommended ≤55–65 dB on the A-scale [49].