Effect of Foot Reflexology on Preterm Neonatal Hyperbilirubinemia

Background & Objective: This study aimed to evaluate the effect of foot reflexology on reducing total serum bilirubin levels in preterm neonates with hyperbilirubinemia. Materials & Methods: A quasi-experimental study was conducted in the Neonatal Intensive Care Unit of Bint Al-Huda Teaching Hospital in Al-Nasiriyah City, Iraq, from May 3 to September 15, 2025. Ninety preterm infants (gestational age 30-37 weeks) were recruited through purposive sampling and randomly assigned to either an intervention group (n=45) or a control group (n=45). The intervention group received a 20-minute foot reflexology session once daily for three consecutive days in addition to routine care, while the control group received routine care only. The primary outcome, total serum bilirubin level, was measured at baseline (before the first session) and on the day after completing the three-day intervention protocol. Data were analyzed using SPSS version 26 with descriptive statistics and the Mann-Whitney U test for group comparisons. Results: Baseline demographic and clinical characteristics were comparable between the two groups. Following the intervention, a statistically significant reduction in total serum bilirubin levels was observed in the intervention group compared with the control group (P=0.001). Conclusion: Foot reflexology demonstrated a significant beneficial effect in reducing bilirubin levels in preterm neonates with hyperbilirubinemia, suggesting its potential as a safe and feasible complementary therapy in NICU settings.