Massage Reduces Bilirubin

  • Subjects:
    • 20 studies included in the review, including 607 infants in the control group and 588 in the intervention group
  • Outcomes: Transcutaneous & serum bilirubin levels
  • Results:
    • Statistically significant linear connection between massage and reduction in transcutaneous & serum bilirubin levels.
    • The greater number of minutes of massage, the lower the bilirubin level.
  • Discussion:
    • Massage increases blood circulation and lymphatic drainage which can lead to better excretion of bilirubin into the stool.
    • Adding massage to traditional treatments can reduce bilirubin levels more quickly, which can decrease length of stay, decrease separation of the infant from the parents and possibly prevent exchange transfusions.
Shahbazi, M., Khazaei, S., Moslehi, S., & Shahbazi, F. (2022). Effect of massage therapy for the treatment of neonatal jaundice: A systematic review and dose-response meta-analysis. International Journal of Pediatrics, 2022, 9161074.

Kangaroo Mother Care Reduces Length of Stay

  • Subjects:
    • 12 studies included in review, including 16,236 infants
      • Control group: Infants received traditional incubator or heated crib care.
      • Experimental group: Infants received Kangaroo Mother Care (KMC) in addition to traditional incubator or heated crib care.
  • Outcomes: Length of stay
  • Results:
    • Infants held skin-to-skin had a statistically significant difference in lower mean hospital stays compared to control group.
  • Discussion:
    • KMC is safe and cost-effective at reducing length of stay.
Narciso, L., Beleza, L., & Imoto, A. (2021). The effectiveness of kangaroo mother care in hospitalization period of preterm and low birth weight infants: Systematic review and meta-analysis. Journal de Pediatria, 98(2), 117-125.

Skin-to-skin by Surrogate has Benefits

  • Subjects:
    • 70 infants, 32-35 weeks PMA
      • Experimental group: Infants were held with KMC 3x/day for 60 minutes each, for 4 days. 1 holding/day was by their mother and 2 holdings/day by a female surrogate family member or friend.
      • Control group: Infants were held only by the mother.
  • Outcomes: Feeding behavior measurements using Premature Infant Breastfeeding Behavior Scale (PIBBS) & physiological function
  • Results:
    • Statistically significant increase in PIBBS scores in both groups without a statistical significance between the 2 groups.
    • No difference in the physiologic function measurements between groups.
  • Discussion:
    • If the mother is not available, skin-to-skin holding by a surrogate can improve feeding behaviors and stabilizing vital signs in the preterm infant, thus promoting growth and reducing length of stay.
Jamehdar, M., Nourizadeh, R., Divband, A., Valizadeh, L., Hosseini, M., & Hakimi, S. (2022). KMC by surrogate can have an effect equal to KMC by mother in improving the nutrition behavior and arterial oxygen saturation of the preterm infant: Results of a controlled randomized clinical trial. BMC Pediatrics, 22(1), 242.

Swaddling & Sucrose Together Reduces Pain

  • Subjects:
    • 60 term infants were assigned to one of 4 groups
      • Sucrose : Infants received 0.2ml/kg of 24% sucrose 2 minutes before the venous draw.
      • Swaddle: Infants were swaddled for 10 minutes before the venous stick, and then for an additional 2 minutes after the blood draw.  During the blood draw, only one arm was removed for the venous stick, and then returned to the swaddle.
      • Swaddle & Sucrose: Infants received the sucrose and swaddle in the methods mentioned above.
      • Control: Infants received no sucrose or swaddle for pain management.
  • Outcomes: The Premature Infant Pain Profile (PIPP) was used to assess pain 2 minutes before, during and 2 minutes after the procedure.
  • Results:
    • Heart rate and mean intensity pain scores were both lower (p=0.006 & p<0.001) during the blood draws in the ‘sucrose & swaddle’ group compared to the controls. Oxygen saturation was also higher (p=0.01) during the blood draw between these two groups.
    • Mean intensity pain scores differed with statistical significance during the blood draw between all four groups. The lowest pain score was recorded in the ‘sucrose & swaddle’ group, followed by ‘sucrose’, ‘swaddle’ and lastly the ‘controls’.
  • Discussion:
    • Using sucrose paired with swaddling was more effective in controlling pain than sucrose or swaddling alone.
    • Other research studies have shown that adding non-nutritive sucking to swaddling and sucrose may further decrease pain scores.
Talebi, M., Amiri, S., Roshan, P. A., Zabihi, A., Zahedpasha, Y., & Chehrazi, M. (2022). The effect of concurrent use of swaddle and sucrose on the intensity of pain during venous blood sampling in the neonate: A clinical trial study. BMC Pediatrics. 22(1), 263.