Nonpharmacological Management of Pain During Common Needle Puncture Procedures in Infants Current Research Evidence and Practical Considerations Carol McNair, RN(EC), MN, NP-Pediatrics, NNP-BC a,b , Marsha Campbell Yeo, RN, PhD, NNP-BC c,d , Celeste Johnston, RN, DEd, FCAHS e,f , Anna Taddio, MSc, PhD b,g, * INTRODUCTION Medical procedures involving needle puncture are ubiquitous in contemporary health care; they are used to diagnose, treat, and monitor medical conditions. Healthy infants undergo about a dozen punctures in their first year of life alone. These procedures routinely include (1) intramuscular injection of vitamin K to prevent hemorrhagic a Nursing, The Hospital for Sick Children, Toronto, Ontario, Canada; b Child Health Evaluative Sciences, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G 1X8, Canada; c School of Nursing, Faculty of Health Professions, Dalhousie University, Halifax, Nova Scotia, Canada; d Department of Pediatrics, IWK Health Centre, Halifax, Nova Scotia, B3K 6R8, Canada; e Ingram School of Nursing, McGill University, 3506 University Street, Montreal, Quebec, H3A 2A7, Canada; f IWK Health Centre, Halifax, Nova Scotia, Canada; g Clinical, Social, and Administrative Pharmacy, Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College Street, Toronto, Ontario M5S 3M2, Canada * Corresponding author. Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College Street, Toronto, Ontario M5S 3M2, Canada. E-mail address: anna.taddio@utoronto.ca KEYWORDS  Needle puncture procedures  Nonpharmacologic pain management  Infants  Needle-related pain KEY POINTS  Needle-related pain is a common experience for infants.  It behooves us to use all possible strategies to mitigate or prevent that pain and its negative consequences.  Current research evidence suggests that nonpharmacologic interventions may be used to help ameliorate needle pain. Clin Perinatol 40 (2013) 493–508 http://dx.doi.org/10.1016/j.clp.2013.05.003 perinatology.theclinics.com 0095-5108/13/$ – see front matter Ó 2013 Elsevier Inc. All rights reserved.