Evaluation of retinopathy of prematurity screening in reverse Kangaroo Mother Care: a pilot study

Abstract

Purpose To evaluate retinopathy of prematurity (ROP) screening practice in reverse Kangaroo Mother Care (R-KMC) with respect to stress and pain to the infant. Methods In a pilot study we evaluated ROP screening practice in R-KMC in 20 babies at risk of ROP. The R-KMC differed from the conventional KMC with respect to the baby position where the baby lay supine on mother's chest. With the mother lying supine and the baby in R-KMC position, screening examinations were done with indirect ophthalmoscope. The outcome measures included stress (quantified by pulse, respiration, and oxygen saturation) and pain to the baby by observing facial expression (eye squeezing, crying, and brow bulge). The heart rate, respiratory rate, and SpO2 (%) were compared before and immediately after the procedure using paired t-test. Result Mean (±SD) gestational age and birth weight were 30.8±2.3 weeks and 1362.5±253.9 g, respectively. During examination in R-KMC position 8 babies (40%) were completely relaxed (no eye squeezing and crying), 10 (50%) were partially relaxed (no brow bulge) and 2 babies (10%) were not relaxed. A change in heart and respiration rate both by 10 per minute was recorded in 12 (60%) and 10 (50%) babies, respectively. Five babies (25%) had reduction in blood oxygen concentration below 92%. The majority of the mothers (19 of 20) were relaxed. Conclusion ROP screening in R-KMC can be a baby friendly screening practice with respect to stress and pain to the infant and needs further evaluation in a larger cohort.

State of the Art in Parent-Delivered Pain-Relieving Interventions in Neonatal Care: A Scoping Review

“…Many studies used more than one outcome variable for pain, and better outcomes were seen in areas such as heart rate, DAN, and NFCS scores, grimacing, and EEG. Some studies, however, showed no better effect for SSC than for other interventions ( 57 , 67 , 68 ) or the control/placebo group ( 69 – 71 ). Soltani et al ( 51 ) found that NIPS scores were higher in the SSC group than in the breastfeeding group.…”

Skin‐to‐skin contact during eye examination did not reduce pain compared to standard care with parental support in preterm infants

“…To be able to conduct an eye examination in a skin‐to‐skin position, the infant was positioned in a supine position. Although supine skin‐to‐skin contact during eye an examination is feasible and appears to provide comfort to the baby , we do not know how it compares to the pain relief provided by traditional skin‐to‐skin contact.…”

“…So far, it has not been investigated if skin‐to‐skin contact has a pain relieving effect during ROP screening. In a pilot study by Padhi et al., they showed that the eye examination was feasible when the infant was positioned in a supine position, skin‐to‐skin on the mother's chest . However, the authors acknowledged the lack of a control group and a valid pain assessment tool that could give additional information.…”

Painful procedures experienced by preterm newborns and evidence-based non-pharmacological methods

“…Taplak and Erdem (2017) compared the effects of breast milk and sucrose on pain reduction during ROP examination to PIPP scores and found that the group receiving breast milk was higher than those in the group receiving sucrose. Padhi et al (2015) in his prospective study examined the effect of kangaroo care in reducing pain during ROP examination and found that kangaroo care was effective in reducing pain.…”