Alternative female kangaroo care for procedural pain in preterm neonates: a pilot study


Celeste Johnston, PO Box 170, Hunts Point, Nova Scotia, CANADA B0T 1G0. Tel: +902 947 2550 | Fax: +514 398 8455 | Email:


Aim:  To determine the feasibility and effect size of kangaroo care (KC) for pain from heel lance in preterm neonates provided by either the infant’s mother (MKC) or an unrelated alternate female (AFKC).

Methods:  Using a randomized crossover design, preterm neonates (n = 18) between 28 and 37 weeks gestational age within 10 days of life from two university-affiliated level III NICU’s undergoing routine heel lance were assigned to receive KC 30 min before and during the procedure from either their mother (MKC) or an unrelated woman. In the second heel lance procedure at least 24 h later but within 10 days, the infants were crossed over to the other condition.

Results:  There was a 48% participation rate, with only 40 of 82 eligible cases having maternal consent. The main reason for refusal was discomfort with another woman providing kangaroo care. The effect sizes on the pain scores (PIPP) were small, ranging from .23 to .43 across the first 2 min of procedure.

Conclusion:  The difference between nonrelated females and the mother in decreasing pain response is small, although not negligible. Given the high refusal rate, nonrelated females are a less desirable alternative to mothers than fathers.