Background: Neonatal pain management has received increasing attention over the past four decades. Research into the effects of neonatal pain emphasises the professional, ethical and moral obligations of staff to manage pain for positive patient outcomes. However, evaluation studies continuously report evidence of inadequate neonate pain management and a gap between theory and practice.Objective: This study reviewed current practice in neonatal pain management to describe the knowledge, attitudes and practices of nurses and doctors regarding pain management for neonates in two academic hospitals.Method: A non-experimental, prospective quantitative survey, the modified Infant Pain Questionnaire, was used to collect data from 150 nurses and doctors working in the neonatal wards of two academic hospitals in central Gauteng.Results: The response rate was 35.33% (n = 53), most respondents being professional nurses (88.68%; n = 47) working in neonatal intensive care units (80.77%; n = 42); 24 (45.28%) had less than 5 years’ and 29 respondents 6 or more years’ working experience in neonatal care. A review of pain management in the study setting indicated a preference for pharmacological interventions to relieve moderate to severe pain. An association (p < 0.05) was found between pain ratings on 5 procedures and frequency of administration of pharmacological pain management. Two-thirds of respondents (64%) reported that there were no pain management guidelines in the neonatal wards in which they worked.Conclusion: The interventions to manage moderate neonatal pain are in line with international guidelines. However, neonatal pain management may not occur systematically based on prior assessment of neonatal pain, choice of most appropriate intervention and evaluation. This study recommends implementation of a guideline to standardise practice and ensure consistent and adequate pain management in neonates.

Kangaroo mother care (KMC) implies placing the newborn pre-term baby in intimate skin-to-skin contact with the mother's chest and abdomen coupled with frequent and preferably exclusive breast-feeding. This is similar to marsupial care-giving, where the premature baby is kept warm in the maternal pouch and close to the breasts for unlimited feeding. KMC has emerged as a non-conventional low cost method for newborn care that provides warmth, touch, and security to the newborn and is believed to confer significant survival benefit. The purpose of this study was to understand the mothers lived experience and perception towards 24-hour Kangaroo Mother Care (KMC) during hospitalization of their preterm babies. Phenomenological study methods were applied through in-depth unstructured interviews, on purposefully selected participants. Their lived experience was analyzed using Collaizzi's steps to phenomenological data analysis. Data analysis revealed three major themes: (a) "it is a bond between me and my child" (b) nurse-parent interaction, and (c) "it is tiring and exhaustive". The study found that all the mothers in spite of exhaustion, reported high level of satisfaction with KMC because it allowed them to be closer to their babies, hence giving them the opportunity to observe their growth and became fully involved in the care. The excellent nurse-mothers' interaction reinforced the KMC concept in care of preterm babies and was rated significant in the transition period of motherhood. The interaction enabled mothers to shift from passive observers to active participants in the care of the preterm babies. KMC was additionally noted to have provided a comforting and warm environment for the babies, thus enabling them to grow faster via weight gains and this in turn increased maternal satisfaction. Recommendation for further research preferably using quantitative methods to establish relationship between production of breast milk and the use of KMC is envisaged. The principle of 24-hour KMC should also be incorporated and emphasized in all levels of preterm baby care hospitals and educational training as this practice has been found to have numerous benefits both to the mothers and to their preterm babies.