title: When alternative female Kangaroo care is provided by other immediate postpartum mothers, it reduces postprocedural pain in preterm babies more than swaddling.
abstract: OBJECTIVE
  Research on alternative female Kangaroo care (KC) has been hampered by high maternal refusal rates. We assessed the efficacy of Kangaroo mother care (KMC), alternative KC provided by other postpartum mothers and swaddling for postprocedural pain relief in preterm babies.
  
  
  METHODS
  The study was carried out in a tertiary armed forces hospital, where mothers did not have support from other female relatives and other postpartum mothers agreed to act as alternative female KC providers. We exposed 51 stable preterm neonates, with a gestational age of 30-36 weeks, to KMC, alternative female KC and swaddling for 30 minutes before heel lancing. The outcome measures included the Preterm Infant Pain Profile (PIPP) scores at 30 seconds and the time taken for the heart rate to return to baseline.
  
  
  RESULTS
  The mean PIPP scores were lower with KMC (10.59) and alternative female KC (11.24) than swaddling (12.96) and heart rate normalisation took 111, 117 and 149 seconds respectively. The p values were <0.001 for individual groups and outcomes. KMC fared better than alternative female KC for both pain (p = 0.045) and heart rate (p = 0.013).
  
  
  CONCLUSIONS
  Providing KMC and alternative female KC before heel lancing resulted in better pain relief than swaddling.
authors.affiliation: Burdwan Medical College, West Bengal, India.
authors.forename: Jitendranath
authors.initials: J
authors.lastname: Murmu
authors.affiliation: Department of Pediatrics, Command Hospital, Pune, India.
authors.forename: Kannan
authors.initials: K
authors.lastname: Venkatnarayan
authors.affiliation: Department of Pediatrics, Command Hospital, Lucknow, India.
authors.forename: Rajeev Kumar
authors.initials: RK
authors.lastname: Thapar
authors.affiliation: Department of Pediatrics, Command Hospital, Kolkata, India.
authors.forename: Subhash Chandra
authors.initials: SC
authors.lastname: Shaw
authors.affiliation: Department of Pediatrics, Armed Forces Medical College, Pune, India.
authors.forename: Shamsher Singh
authors.initials: SS
authors.lastname: Dalal
mesh_terms: D017028:Caregivers / Q000706:statistics & numerical data*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D060127:Kangaroo-Mother Care Method; D059408:Pain Management / Q000379:methods*; D000073818:Procedural Pain / Q000517:prevention & control*
keywords: Alternative female Kangaroo care; Heel lancing; Kangaroo mother care; Preterm Infant Pain Profile; Swaddling