July 2022 Newsletter – Literature Summaries2022-07-01T12:19:42-04:00
Kangaroo Mother Care Reduces Length of Stay
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
Infants held skin-to-skin had a statistically significant difference in lower mean hospital stays compared to control groups
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
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
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.
If the mother is not available, a surrogate supports providing improved 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, 242. DOI: 10.1186/s12887-022-03316-z
Massage Reduces Bilirubin
20 studies included in the review, including 607 infants in the control group and 588 in the intervention group
Outcomes: Transcutaneous & serum bilirubin levels
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
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. https://doi.org/10.1155/2022/9161074.
Swaddling & Sucrose Together Reduces Pain
60 term infants were assigned to one of 4 groups
I – Sucrose : Infants received 0.2ml/kg of 24% sucrose 2 minutes before the venous draw.
II – 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.
III – Swaddle & Sucrose: Infants received the sucrose and swaddle in the methods mentioned above.
IV – Control: Infants received no sucrose or swaddle for pain management.
Outcomes: The Neonatal Pain Measurement Scale (PIPP) was used to assess pain 2 minutes before, during and 2 minutes after the procedure.
Heart rate and oxygen saturation in the control group and the ‘sucrose & swaddle’ group were statistically significant during the blood draw.
PIPP scores were also statistically significant during and after the blood draw in the study groups.
Using sucrose paired with swaddling was more effective in controlling pain than sucrose or swaddling alone.
More studies have shown that adding non-nutritive sucking to swaddling and sucrose may further decrease pain scores.
Talebi, M., Amiri, S., Roshan, P., Zabihi, A., Zahedpasha, Y., Chehrazi. (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, 263.