Kangaroo Care (Skin-to-Skin) for Clustered Pain Procedures: Case Study

Abstract

Background: Pain management for term newborns undergoing clustered painful procedures has not been tested. Kangaroo Care (chest-to-chest, skin-to-skin position of infant on mother) effectively reduces pain of single procedures, but its effect on pain from clustered procedures is not known. Aim: The aim was to test Kangaroo Care's effect on pain in one term infant who received clustered painful procedures while determining feasibility of the Kangaroo Care intervention. Design, Setting, and Participant: A case study design was used with one healthy term newborn who received two heel sticks and one injection in one session in the mother's postpartum room. Method: Heart rate and oxygen saturation (recorded from Massimo Pulse Oximeter every 30 seconds), crying time (total seconds of crying on videotape) and behavioral state (using Anderson Behavioral State Scoring system every 30 seconds) were measured before (5 minutes), during (10.5 minutes) and after (30 minutes) the three clustered painful procedures in a newborn who was in Kangaroo Care during all observations. One staff nurse administered the clustered procedures. Results: Heart rate increased sequentially with each heelstick, oxygen saturation remained unchanged, sleep predominated, and crying was minimal throughout the procedures. Conclusion: Kangaroo Care appeared to reduce pain from clustered painful procedures and can be further tested.

The evolution of the science of kangaroo (mother) care (skin‐to‐skin contact)

“…During and after vaccine injection, KC infants had lower physiologic responses, cry time and pain scores defining level of pain by the neonatal/infant pain scale (Kostandy, Anderson, & Good, ; Saeidi, Asnaashari, Amimejad, Esmaeili, & Robatsangi, ). A case study of KC effects on minimizing pain responses during and after clustered painful procedures (multiple painful procedures given in the same session one after the other) were reported and more investigation in this area is recommended (Kostandy & Ludington‐Hoe, ). A new robotic technology “Calmer” was designed to mimic KC (Holsti, MacLean, Oberlander, Synnes, & Brant, ).…”

Clustered Pain Procedures in Skin-to-Skin Contact (SSC) Position for Full Term Newborns

“…Sources of repeated pain in the neonatal period are the invasive procedures needed to obtain bilirubin and glucose samples, testing blood for phenylketonuria, and administration of Vitamin K and Hepatitis B injections prior to discharge in healthy full term newborns. SSC has been confirmed as an effective non-pharmacologic pain reduction intervention when provided by the mother or father [13] [14], and when given alone [15] [16] [17] or in combination with breastfeeding [18], sucrose [19], and rocking [20]. SSC relieves pain from heel-stick [21] [22] [23], injection [15] [16] [24], or venipuncture [25].…”