Our instinct upon hearing a baby cry is to ease their woe and soothe them. We want nothing more than to alleviate their troubles when they are ill. As a nurse, Denise Harrison witnessed the discomfit of babies when undergoing necessary treatment. She was driven to make things less painful for them, to develop strategies to minimise their distress- and in turn, that of their families and carers. It has turned into her life’s work and taken her around the world, working with researchers, medical professionals, graduate students and families. We caught up with Denise to learn more about her field of work and the ways that families and playgroups can learn from, and make use of, her findings.

Empowering parents to Be Sweet to Babies during immunisations and medical procedures

What have children taught you most in your role as a nurse and midwife?

Small sick babies in the NICU and healthy newborns have taught me the importance of ensuring that providing comfort during necessary, but painful procedures is so important. Exploring best evidence, then putting this evidence into place, while working with parents of sick and healthy babies, and nurses and midwives caring for sick and healthy babies is key to our work.

Playgroup is a great space to share and gather knowledge. In what ways could playgroup leaders engage with nurses and your resources to assist families as their children develop and grow?

Knowledge that parents of babies and young children need, includes how to comfort their children during needles. Having easily accessible up to date information for families, that playgroup leaders could share with family members and nurses and midwives, will help ensure this knowledge is available and accessible.

Our hope is that families transition from their maternal child health engagement to a baby playgroup for continued support and the building of a social network. What benefits have you found, in the passing on of knowledge in group spaces?

Passing on knowledge in group spaces increases the chances that changes are made and sustained. Creating excitement, creating lively debate, sharing of stories, can occur in group spaces. Necessary but painful experiences for babies and young children is something all parents share and ways to reduce pain is of key interest. Sharing information about how parents can help their babies during the painful newborn heel pricks and early childhood vaccinations will help parents and prospective parents use the known effective strategies during subsequent needles.

In what ways would you like to engage with families to empower them?

We have been working with families to co-produce our series of BSweet2Babies videos which show babies having their heel lances and vaccinations while being breastfed, held skin-skin or given sucrose. We would like to co-produce another video showing a small baby being held by a Dad, skin-skin during the baby’s heel lance. Working with Dads, as well as Mums, will help demonstrate to Dads how they can also help comfort their baby during painful procedures.

In what ways can your collection of videos assist families?

The series of BSweet2Babies videos is targeted at parents of babies, with one, our newest video, targeted at nurses and midwives.

The parent-targeted videos demonstrate:
i) the effectiveness of breastfeeding, skin-skin and sucrose in newborn babies during heel pricks and venipuncture (View HERE)
ii) breastfeeding a 2-month old during vaccination (View HERE)
iii) breastfeeding an 8-month old during vaccination (View HERE) and sucrose during vaccination (View HERE)

These were all co-produced with parents as well as nurses, hospital organisations and the Baby Friendly Hospital Initiative group endorsed these videos. The ways they can assist families is through them seeing how powerful breastfeeding, skin-skin and sucrose are in keeping babies comfortable during needles, and helping parents to advocate to doctors and nurses to support them to use these methods. The voice-over is in very user-friendly language, and the videos are produced in 10 languages so they’re accessible to many parents. Finally, the staff targeted video is for nurses and midwives (View HERE). This focuses on one specific barrier reported by nurses and midwives to supporting mothers to hold their babies during heel pricks, for example, they did not know how to position themselves to do the heel prick. So, our team partnered again with parents, nurses, midwives and organisations, but also an occupational health physiotherapist to produce this video which clearly shows and describes, best ergonomics for clinicians to take babies’ blood while mothers are breastfeeding and holding their babies skin-skin, in either a bed or sitting in a chair. It is hoped that this video will be used by nurses and midwives in their education.

Denise pictured with the BSweet2Babies team, Ottawa, Canada

You are the lead of the BSweet2Babies team at the University of Melbourne. How did this research begin?

As a NICU nurse, along with the whole NICU team, I caused pain in sick and premature babies, during necessary procedures such as heel pricks, venipuncture, intravenous line insertions and many other procedures. It was during one particular procedure in a sick baby with chronic lung disease who became extremely distressed, then his condition worsened, that I knew we had to urgently explore and implement better pain treatment during the frequently performed painful procedures. From this day I set out to study best ways to reduce pain. My research started with finding that small volumes of sugar water reduced pain in our population of very sick babies in the NICU. This was just the start. We now know that breastfeeding when possible and holding premature hospitalized babies skin-to-skin also effectively reduce pain. Along with all my paediatric pain research colleagues around the world, we are working on getting this knowledge into normal care for all babies.

You spent ten years in Canada as the inaugural holder of the Research Chair in Nursing Care of Children, Youth and Families at the University of Ottawa and Children's Hospital of Eastern Ontario. What was the most rewarding part of this time?

This was my first research academic leadership position where I was able to both take the lead in my own research, but also be a team member with other researchers in Canada and throughout the world. In this role, I was also able to supervise students doing their Masters and PhD, and also postdoctoral fellows, which was, and remains, one of the most rewarding parts of my role for me. My work with teams in China and Brazil was incredibly rewarding, as knowledge and access to knowledge from our English work is limited. Seeing how our BSweet2Babies work is embraced in these countries through my teams has been exciting and rewarding. Plus…it’s not all about research. I loved learning how to embrace the long very very cold winters. Learning to ice skate, then pushing my postdoctoral fellow from Brazil in a sled along the longest skating rink in the world, the Rideau canal, was incredibly rewarding and lots of fun.

Back in Melbourne, are you hoping to share much of your knowledge and research obtained over the ten years you were working in Canada?

I returned to Melbourne in 2020 and have been working at best ways to share all our BSweet2Babies research and videos and evaluate how accessible, acceptable and effective the videos are for parents and for clinicians. This work is ongoing, and once again, I am working with new students and postdoctoral fellows, new organisations, new teams, new parent groups, to ensure our work is shared as widely as possible. Working with Playgroup Victoria is a fantastic opportunity to share knowledge with large numbers of families and Playgroup Victoria leaders. I look forward to all future work with Playgroup Victoria.

As a nurse, what do enjoy most about working with babies, children and their families?

Although I have not worked clinically for many years, my role as a Professor of Nursing, keeps me focused on clinically important issues. My research focus is on pain in babies and young children, and working with families to help ensure best pain management for sick and healthy babies and children. This focus came directly from my clinical work in the Neonatal Intensive Care Unit (NICU), where it became evident that we needed to urgently improve how we provided comfort during the frequent and repeated episodes of painful procedures. Since my first study where I showed that very small amounts of sucrose (sugar water) reduced pain in sick babies in the NICU during heel pricks, my team’s research has grown and our BSweet2Babies work is now known around the world. This is what I enjoy – knowing that our collective work is helping babies and parents around the world.

LEARN MORE AND CONNECT WITH THE BE SWEET TO BABIES TEAM ON SOCIALS HERE

Article by Sinead Halliday