The effect of foot reflexology, breastfeeding and kangaroo care on pain before heel blood collection in newborns

Objective: It is aimed to comparatively investigate the effects of foot reflexology massage, kangaroo care and breastfeeding, which are non-pharmacological applications to be applied before heel blood collection, in reducing pain in newborns. Material and Method: The study was conducted in four groups, randomized controlled, experimental design and double-blind. The research was carried out between 25/12/2021–25/12/2022 in Malatya Training and Research Hospital, Obstetrics and Gynecology wards. The sample of the study consisted of 144 newborns in the Reflexology group (36), Kangaroo care group (36), Breastfeeding group (36) and Control group (36). Neonatal information form, NIPS scale, saturation device and camera were used to obtain the data. Among the descriptive statistics, Dunn, Wilcoxon, Z test, chi-square test, Kruskal walls and Intraclass Correlation (ICC) tests were used to evaluate the data. Results: In our study, there was no statistically significant difference between the average crying times of babies between the groups (p=0.573). There was no statistically significant difference between the oxygen saturation and the median heart rate measured before and after the procedure in each group (p>0.050). There was no statistically significant difference between median NIPS values in the researcher's reflexology, kangaroo and breastfeeding and control groups during the procedure (p=0.299). A statistically significant difference was found between the median NIPS values of the groups (reflexology, breastfeeding, kangaroo and control) measured before, during and after the procedure (p<0.001). There was no statistically significant difference between the median NIPS values of the blind evaluator during the procedure (p<0.001). A statistically perfect agreement was obtained between the NIPS values obtained by the investigator and the blinded evaluator during the procedure (ICC=0.942; p<0.001). Conclusion: In our study, foot reflexology, kangaroo care and breastfeeding were not effective in reducing the pain during the procedure of heel blood collection from babies; It has been found that it is effective in the pain experienced by the baby before and after the procedure and relieves the baby. Keywords: pain, breastfeeding, kangaroo care, reflexology, newborn