Kangaroo Care May Reduce Pain During Repeated Painful Procedures in Infants

Kangaroo care may effectively reduce pain over repeated painful procedures in infants in neonatal intensive care units.

Kangaroo care, or maternal skin-to-skin contact, may effectively reduce pain over repeated painful procedures in infants in neonatal intensive care units, according to study results published in Pain.

In this single-blind randomized trial conducted to examine the relative sustained efficacy of kangaroo care and sweet-tasting solutions (eg, sucrose), 242 stable preterm infants (mean gestational age, 32 weeks) in a neonatal intensive care unit were randomly assigned to receive kangaroo care and water (n=81), kangaroo care and 24% sucrose (n=80), or sucrose only (n=81) before 3 medically indicated heel lances. Baseline characteristics were similar between groups among mothers and infants.

Pain intensity in infants was evaluated with the Premature Infant Pain Profile at 30, 60, 90, and 120 seconds after heel lance. Scores on the Premature Infant Pain Profile were highest in the 30 seconds after heel lance (first, second, or third) in all groups, with no significant intergroup differences. The percentage of infants was comparable for all 3 levels of pain (ie, mild, moderate, or severe). Severe pain occurred in an estimated 0% to 12% of infants, regardless of group.

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Neurobehavioral Assessment of the Preterm Infant scores (motor development, vigor, alertness, and orientation subscales) were comparable between groups at 32 weeks±10 days or 36 weeks±10 days.

There were also no significant intergroup differences in the need for additional off-protocol sucrose dosing, the occurrence of adverse effects, the need for an additional heel lance procedure, the total volume of blood drawn, or the number of previous painful procedures.

Study limitations include the small sample size, and the inability to blind care providers.

“Our findings challenge the existing recommendation of using sucrose as the primary standard of care for the management of repeated tissue-breaking procedures for preterm neonates undergoing procedural pain. Clinicians should consider [kangaroo care] as at least an equivalent alternative,” concluded the study authors.

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Campbell-Yeo M, Johnston CC, Benoit B, et al. Sustained efficacy of kangaroo care for repeated painful procedures over neonatal intensive care unit hospitalization: A single-blind randomized controlled trial [published online July 22, 2019]. Pain. doi:10.1097/j.pain.0000000000001646