Kangaroo mother care diminishes pain from heel lance in very preterm neonates: A crossover trial

Abstract

Background: Skin-to-skin contact, or kangaroo mother care (KMC) has been shown to be efficacious in diminishing pain response to heel lance in full term and moderately preterm neonates. The purpose of this study was to determine if KMC would also be efficacious in very preterm neonates.

Os efeitos da posição canguru em resposta aos procedimentos dolorosos em recém-nascidos pré-termo: uma revisão da literatura

“…According to Johnston et al, (5) maternal sensorial stimuli added during kangaroo care failed to show additional effects in PN as compared with conventional kangaroo care. However, this should be added as nonpharmacological care during painful PN procedures.…”

“…(6) However, painful procedures in PN should be minimized and performed with frequent use of analgesia when necessary. (2) According to Johnston et al, (5) the effects of topical anesthesia in extreme preterm neonates are not known, and repeated use of sucrose requires additional investigation to determine safety and effectiveness, especially in very-low-birth-weight children who are a few days old. However, non-nutritive suction has shown significant beneficial effects in extremely premature neonates.…”

“…(5) The Brazilian Ministry of Health defines kangaroo care as a type of neonatal assistance implying early progressive skin contact between a mother and a lowbirth-weight neonate, for however long both consider it to be pleasant, thereby providing additional parental involvement in the child's care. The kangaroo position itself consists in maintaining the lightly dressed lowbirth newborn in a prone vertical position against the adult's chest.…”

“…(7) The already known and assessed advantages of this method are increasing the mother-child connection, avoiding long periods without sensitive stimulation, stimulating breastfeeding, increasing parental competence and confidence in handling their baby, providing better thermal control, reducing hospital infection and hospital length of stay and promoting analgesic effects. (5,8,9) Mother-child relationship effects were studied in animals. Champagne et al (10) have shown that rats receiving more licks and care during their first 6 days of life showed more cerebral plasticity in adult life, e.g.…”

“…(1) Premature neonates (PN) usually require NU care, where they spend their first weeks of life and often undergo painful routine procedures (2)(3)(4)(5) such as endotracheal intubation, heel punctures, venous and arterial catheterization in addition to nasal, tracheal and gastric suctions. (2) Due to the immaturity of their nervous system, PN are highly sensitive to pain.…”