Comfort Positioning for Pediatric Procedures

Comfort positions, or “comfort holds,” are ways that caregivers can hold infants and children during stressful procedures in a way that promotes the patient’s comfort while simultaneously minimizing their movement. In this way, we are limiting the stress and trauma the child will experience but allowing the healthcare worker to accomplish the procedure successfully.

Benefits:

• Provides comfort through close contact with caregiver

• Child feels safer, supported, and a sense of control

• Successfully immobilizes extremity for procedure

• Avoids negative restraining which can be very traumatic

• Caregiver can participate in positive assistance and feel like they have a job rather than feeling helpless

• Fewer people are needed to complete procedure.

• Uses principles of family-centered care

• Enables easier use of distraction

Common Types of Holds:

1. Back to chest: For procedures like blood draws, IVs, and NG tubes, the child sits with their back to the caregiver’s front, and the caregiver wraps their arms around the child from behind like a hug. If necessary, parent can wrap their legs over the child’s legs to provide extra stability

2. Chest to chest: For procedures like injections, the child faces caregiver and straddles their lap and they can hug each other while the nurse can access the patient’s arm or leg

3. Legs around torso: For procedures on face (like sutures), patient lies on their back and wraps legs around caregiver, who is facing towards the child and can hold their hands

4. Infant hold: Allow caregivers to hold or lay with infant. If not possible, at least allow the caregiver to stay close and provide positive words and touch (extra points for pacifier + sucrose)