The effectiveness of swaddling and maternal holding applied during heel blood collection on pain level of healthy term newborns; randomized controlled trial

ABSTRACT

This study was a prospective, randomized controlled trial. The study sample consisted of 105 healthy neonates who conformed to the case selection criteria. Neonates were randomly assigned to the following groups: swaddling (S), maternal holding (MH), and controls (C). The study data were obtained using an information form and the Neonatal Infant Pain Scale (NIPS). There were no statistically significant differences between total crying times (C: 81.14 ± 44.93; S:79.28 ± 40.74; MH: 69.42 ± 31.10 sec.) and the time to first calming (C: 71.28 ± 50.87; S: 59.74 ± 42.40; MH: 54.85 ± 35.61) of heel stick procedures between all groups (p>.05). It was observed that procedural pain levels were the lowest in the maternal holding group (5.57 ± 1.24), followed by swaddling (5.82 ± 0.92), and the control group (6.40 ± 0.91). As a result, both swaddling and maternal holding are effective at reducing pain felt during heel stick procedures, but mother holding may be preferred as a priority rather than swaddling.

Trial registration: ClinicalTrials.gov identifier: NCT04625010.

KEYWORDS:

• Newborn
• swaddling
• heel stick
• maternal holding
• non-pharmacologic methods
• pain management

Acknowledgements

The authors thank the parents and their babies for participating.

Disclosure statement

This research received no specific funding. The authors have no conflicts of interest to declare.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.

Notes on contributors

Sevil Inal

Sevil Inal a professor of Midwifery Department in Istanbul University- Cerrahpasa, Faculty of Health Sciences, writes on nonpharmacological pain management of newborn and children. Among her recent articles are “The effect of external thermomechanical stimulation and distraction on reducing pain experienced by children during blood drawing. (Pediatric emergency care, 2020) and ”Impact of peripheral venous catheter placement with vein visualization device support on success rate and pain levels in pediatric patients aged 0 to 3 years" (Pediatric emergency care, 2021).

Diler Aydin Yilmaz

Diler Aydin Yilmaz a professor of Pediatric Nursing Department in Bandirma Onyedi Eylül University, Faculty of Health Sciences, writes on nonpharmacological pain management of children. Among her recent articles are “Effects of breastfeeding and heel warming on pain levels during heel stick in neonates. (International journal of nursing practice, 2019) and ”Effects of music therapy and distraction cards on pain relief during phlebotomy in children". (Applied Nursing Research, 2017).

Leyla Erdim

Leyla Erdim a Dr. Nurse of Midwifery Department in Istanbul University- Cerrahpasa, Faculty of Health Sciences, writes on nutrients and pain management in children. Among her recent articles are “Reliability and validity of the Turkish version of the Physical Activity Questionnaire for Older Children (PAQ-C). (Turkish journal of medical sciences, 2019) and ”The effect on pain and anxiety levels of using DistrACTION® Cards to distract children during a skin-prick test: a randomized controlled experimental study. (Minerva Pediatrics, 2021).