Impact of Kangaroo Mother Care on Heart Rate Variability and Pain Score with Heel Lance Pain in Preterm Neonates: A Cross-over Randomized Controlled Trial

Introduction: To evaluate the effect of kangaroo care on response to pain due to heel lance in preterm infants using premature infant pain profile (PIPP). Design: Randomized cross-over design. Methods: Stable preterm neonates ( n = 70) who had completed 28–36 weeks of gestational age received either kangaroo mother care or were kept under control (bassinet) conditions for 30 minutes prior to a heel lance. The neonates were observed, and responses were scored as per PIPP. They were then crossed over to the other condition and scored similarly. The PIPP scores in the two study arms were then compared using appropriate statistical tools. Results: A total of 342 neonates were admitted during the study period, of which 95 were assessed for eligibility, and finally, 70 were included and randomized to be in one of the two arms. The facial actions differed in the two groups; the brow bulge and eye squeeze scores were significantly better at each observation in the KMC group. The nasolabial furrow score was significantly better at 60 and 90 seconds. The baseline PIPP scores were similar. In the KMC group, the scores were significantly lower at 30, 60, and 90 seconds post–heel lance. Conclusions: Kangaroo mother care is an effective way of reducing the physiological and behavioral effects of pain in preterm neonates.