The effect of kangaroo care in relieving pain of vaccination procedures in newborns in a hospital in Saudi Arabia

BACKGROUND: Routine newborn immunizations cause significant procedural pain, and available comfort measures may not fully relieve this distress. Kangaroo care (KC) supports neonatal physiological stability, yet its effect on acute immunization pain in healthy full-term infants remains insufficiently defined. OBJECTIVE: To determine whether KC reduces vaccination-related pain when combined with standard sucrose analgesia, with pain intensity during injection specified as the primary outcome. METHODS: A randomized controlled trial was conducted with 200 healthy full-term newborns allocated to either KC or standard care during vaccination. All infants received 24% oral sucrose before injection. Pain was evaluated using the Neonatal Infant Pain Scale (NIPS) before, during, and immediately after vaccination, and crying duration was recorded. RESULTS: KC infants had significantly lower NIPS scores during injection compared with controls (mean 1.59 ± 1.06 vs. 2.32 ± 0.76; mean difference -0.73, 95% CI -0.95 to -0.51, p < .001). During vaccination, 81% of KC infants versus 59% of controls had NIPS scores of 0-2, and 22% versus 3% showed no pain. After vaccination, 78% of KC infants versus 26% of controls had NIPS = 0. Crying duration was markedly shorter with KC (10.3 ± 14.8 vs. 36.9 ± 24.0 s, p < .001). CONCLUSIONS: KC is a simple, feasible non-pharmacological strategy that can reduce pain responses and crying duration during newborn vaccination. IMPLICATIONS FOR PRACTICE: KC can be incorporated into routine immunization procedures to enhance infant comfort, potentially strengthening family-centered care within immunization settings.