Effects of non-nutritive sucking combined with kangaroo care during blood sampling from the heel of newborns.

BACKGROUND

The quality of heel blood sampling is critical to the accuracy of neonatal disease screening. However, neonates inevitably experience pain during heel-lance procedures, and repeated painful stimuli may adversely affect neural development. This study aimed to evaluate the effectiveness of non-nutritive sucking combined with kangaroo care in improving procedural outcomes during heel blood sampling in newborns.

METHODS

This was a single-centre, non-randomised, quasi-experimental historical-control study. A total of 186 full-term newborns delivered vaginally and undergoing heel blood sampling for neonatal disease screening in the Department of Obstetrics at Huzhou Maternal and Child Health Hospital between July 2024 and June 2025 were included. According to the calendar period, newborns were included in a historical control group receiving routine care from July to December 2024 (n = 102) or an intervention group receiving non-nutritive sucking with a pacifier combined with kangaroo care from January to June 2025 (n = 84). Outcomes assessed included first-attempt success rate, blood drop diameter, bleeding time, and Neonatal Infant Pain Scale (NIPS) score. Adverse events such as hematoma, bleeding, and ecchymosis were also documented.

RESULTS

The intervention group demonstrated a significantly higher first-attempt success rate (97.62%) compared with the control group (83.33%; P < 0.05). The blood drop diameter in the intervention group (11.28 ± 2.03 mm) was greater than that in the control group (10.02 ± 1.85 mm; P < 0.05), while bleeding time was significantly shorter (2.48 ± 0.37 s vs. 3.51 ± 0.30 s; P < 0.05). The NIPS score during sampling was also markedly lower in the intervention group (3.36 ± 0.41) than in the control group (5.23 ± 0.68; P < 0.05). Additionally, the overall incidence of adverse puncture events was 10.71% in the intervention group, significantly lower than that the 22.55% observed in the control group (P < 0.05).

CONCLUSION

The combination of non-nutritive sucking and kangaroo care was associated with favourable outcomes in neonatal heel-prick blood sampling, including higher first-attempt success, larger blood-drop diameter, shorter bleeding duration, lower procedural pain, and fewer puncture-related adverse events. These findings suggest that the combined intervention may be a feasible non-pharmacological approach for neonatal procedural pain management.