Which Kangaroo Mother Care Position Best Supports Neonatal Stability During Heel Lancing?

Background: Heel lance is a common invasive procedure causing acute pain in neonates. Although the pain-relieving effects of kangaroo mother care (KMC) are well documented, the impact of different KMC positions remains uncertain. Purpose: This study aimed to evaluate the impact of 3 different KMC positions (classic, lateral, and reverse) on neonatal pain, comfort, and physiological parameters during the heel lancing procedure. Methods: Sixty-three term neonates were randomly assigned to 1 of 3 KMC groups: classic (n = 21), lateral (n = 21), or reverse (n = 21). The Neonatal Infant Pain Scale (NIPS), the COMFORTneo Behavior Scale, and a physiological parameter monitoring form were used to collect data. Assessments were performed at 5 sequential time points: baseline (-3rd minutes), lancing (0 minutes), during the procedure (10th sec and 1st minutes), and postprocedure (3rd minutes). Results: No significant differences were observed between groups in NIPS scores, heart rate, or SpO 2 levels across all evaluated time points ( P > .05). Pain scores peaked at the 10th second across all groups. However, when evaluating COMFORTneo scores across all time points (baseline, during, and postprocedure), the reverse group exhibited significantly lower overall comfort levels (higher COMFORTneo scores) compared with the classic and lateral groups ( P < .05). Crying durations were similar, although the lateral group recorded the shortest duration (lateral < classic < reverse). Implications for Practice and Research: Classic or lateral KMC positions should be prioritized during heel lancing to enhance comfort. Future research should include biochemical markers like salivary cortisol and evaluate the reverse KMC position for neonates where standard positions are medically restricted.