Comparing Kangaroo Mother Care and Expressed Breast Milk as Non-pharmacological Strategies for Reducing Procedural Pain in Neonates: A Randomized Controlled Trial.

Background: Neonates in neonatal intensive care units frequently endure painful procedures, such as adhesive tape removal, often without adequate pain management. Non-pharmacological interventions like kangaroo mother care (KMC) and expressed breast milk (EBM) administration have shown promise in alleviating neonatal pain. However, comparative data on their efficacy for specific procedures are limited.

Objective: This study compares the effectiveness of KMC and EBM in reducing procedural pain during adhesive tape removal in low-birth-weight neonates.

Methods: In this randomized controlled trial conducted at a tertiary care neonatal intensive care unit, 100 low-birth-weight neonates were randomized into KMC and EBM groups. Procedural pain during adhesive tape removal was assessed using the Premature Infant Pain Profile (PIPP) score, incorporating heart rate (HR), oxygen saturation (SpO₂), and facial expressions pre- and post procedure. Video recordings were analyzed by a single trained assessor to ensure reliability.

Results: The baseline characteristics of both groups were comparable. Post-procedure PIPP scores were slightly lower in the KMC group (11.02 ± 2.39) than the EBM group (11.19 ± 2.22), but the difference was not statistically significant (p = 0.704). HR, SpO₂, and facial expression parameters were also similar between groups. Difference in pre- and post-procedure PIPP scores in KMC (4.41 ± 1.72) and the EBM group (4.04 ± 1.50) was also comparable (p = 0.275).

Conclusion: KMC and EBM are equally effective, low-cost, and accessible strategies for procedural pain management in neonates. This study highlights the importance of integrating non-pharmacological pain relief methods into routine neonatal care.