“Babies are still weeping.” Mothers’ perspectives regarding infants’ pain during vaccination in a low resource setting

Abstract

Vaccination has been successful in reducing the incidence of vaccine-preventable diseases and deaths. However, pain experienced by  infants during the vaccination process is a source of distress for both the baby and her mother. If left untreated, this pain can result in  negative consequences such as impaired brain development, a fear of needles, avoidance of healthcare facilities, and a reluctance to  vaccinate in the future. Despite the World Health Organization's recommendations on managing infant pain during vaccination, mothers  in Ghana are unaware of these guidelines and do not follow them, indicating a gap between evidence and good clinical practice. There  are limited published studies on infant pain management practices, especially in low-resource environments where procedural pain is  often not addressed. Therefore, this study explored mothers' perspectives on pain and its management during infant vaccination. Using  a qualitative descriptive approach, semi-structured in-depth interviews were conducted with 30 mothers who brought their infants to three different children welfare clinics in Accra for vaccination over a period of three months. The data were analysed using Tesch's  content analysis procedure. Three themes emerged: Mothers’ awareness of infants’ pain, infants’ expression of pain, and the current  pain assessment and management practices by mothers. The mothers indicated infants’ express pain through their behaviours and  emotions. Even though the mothers were aware of the pain, they did not use evidence-based WHO interventions such as breastfeeding  to manage infant pain during vaccination because they were unaware of these strategies and discouraged from using breastfeeding  during vaccination. Mothers need to be educated on the use of the WHO recommendations for pain management in infants during  vaccination and on how to advocate for good clinical practice from health care professionals.