Comparing the effects of foot reflexology, kangaroo care, and standard care on bilirubin levels in preterm infants with physiological jaundice undergoing phototherapy in neonatal intensive care unit: a randomized controlled trial

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Neonatal hyperbilirubinemia is a prevalent condition worldwide. This study compared the effects of foot reflexology massage and Kangaroo Mother Care on bilirubin levels in infants undergoing phototherapy. A randomized clinical trial was conducted between July and October 2023 on 84 pre-term neonates with jaundice at Shahada Medical Education Hospital in Qom. Participants were randomly assigned to three groups: foot reflexology massage, kangaroo care, and control. Infants in the reflexology group received a massage in specific areas, while those in the Kangaroo Mother Care group underwent skin-to-skin contact with their mothers. Infants in the foot reflexology group received a massage of 15 min on each foot once daily (30 min per session), while the Kangaroo Mother Care group underwent at least five 30-minute skin-to-skin contact sessions per day. The control group received no intervention, but all three groups underwent phototherapy. Interventions commenced within the first 24 h of hospitalization. Serum bilirubin levels were measured during and 24 h after hospitalization. Data were analyzed using SPSS Version 22, with a significance level of p < 0.05. Serum bilirubin levels were comparable at baseline among the foot reflexology (16.07 ± 2.51 mg/dL), KMC (16.29 ± 1.84 mg/dL), and control (16.56 ± 3.14 mg/dL) groups ( n = 28 each) ( p = 0.77). Levels progressively decreased at 24, 48, and 72 h in all groups ( p < 0.05). At 72 h, bilirubin levels were 11.44 ± 2.02 mg/dL ( n = 9) in reflexology, 12.08 ± 1.68 mg/dL ( n = 12) in KMC, and 14.02 ± 3.14 mg/dL ( n = 16) in controls ( p < 0.05), with greater reductions observed in the intervention groups. The findings suggest that foot reflexology massage and Kangaroo Mother Care can effectively reduce blood bilirubin levels in neonates. IRCT20210501051142N3, Registration date 20,220,802. Link: https://irct.behdasht.gov.ir/trial/64881 .