ery premature babies have been shown, through research recently conducted in Canada, to have a reduced incidence of pain when heel pricks are being done as a part on their care whilst in hospital. The study showed that preemie babies benefited form skin-to-skin contact with their moms during painful medical procedures such as heel pricks.
Heel pricks are done as a part of neonatal care. It is a common procedure involving taking a blood sample from the heel of newborn baby as part of their premature care. This is also a practice with full term babies as well. A pinprick puncture is made on the heel of the baby’s foot, and the blood from this pinprick is placed on what are known as Guthrie cards. The sample of blood is then used for undertaking variety of genetic tests which include testing for;
• The detection of phenylketonuria, an enzyme deficiency that can impair brain development.
• Thyroid stimulating hormone (TSH) to detect hypothyroidism and the prevention of cretinism.
• The detection of trypsin to detect cystic fibrosis.
Cystic fibrosis is an inherited disease of the lungs and the digestive tract. It causes thick, sticky mucus to build up and is one of the most common chronic lung diseases in babies and children.
Cretinism is a condition in which there is severely stunted physical and mental growth within a newborn baby. This is due to untreated congenital deficiency of thyroid hormones (congenital hypothyroidism) which is in turn due to a maternal nutritional deficiency of iodine.
Galactosemia is a rare genetic metabolic disorder that affects a baby’s ability to metabolize the sugar galactose normally.
Heel pricks are undertaken between 48 and 72 hours after birth in newborn babies. The reason that the test is done after 48 hours post birth is that false results may occur before this time.
With genetic tests becoming more common, a wide variety of tests may use the blood drawn by this method. Many neonatal units (SCBUs) now use this method to carry out the daily blood tests (blood count, electrolytes) required to check the progress of ill neonates.
In the study, 61 premature infants born between 28 to 31 weeks of gestation who had heel pricks done for testing at least twice before they were discharged from hospital. The first heel lance was done whilst the preemie baby was swaddled and lying in their incubator. The second heel prick was done after the mother had held the diaper-clad infant for 15 minutes between her breasts, providing maximal skin-to-skin contact and doing Kangaroo Mother Care. The pain that the preemie baby felt was measured in severity by using a scale that measured their heartbeat, oxygen saturation of the blood and other behavioral indicators like facial expression and crying.
What was found through the research was that average pain scores, reported did not differ between the two lances at 30 and 60 seconds after the procedure. However, the premature baby’s who were held in the KMC position by their Mothers for at least two minutes after the heel prick only had half as much pain as the baby’s in the incubators.