Facilitated tucking versus Kangaroo mother care in alleviating BCG vaccination -associated pain in preterm neonates ≥34 weeks: a randomized controlled trial

Neonatal pain is a critical yet often under-recognized clinical issue, particularly in preterm infants who demonstrate heightened sensitivity due to neurological immaturity. Procedural pain, including vaccination, may have both immediate physiological effects and long term neurodevelopmental consequences. The present study aims to compare the effectiveness of facilitated tucking and kangaroo mother care (KMC) in reducing pain during Bacillus Calmetteâ€"Guérin vaccination in preterm neonates with corrected gestational age ≥34 weeks. This randomized controlled trial was conducted in a tertiary neonatal intensive care unit (NICU) between 2022 and 2024. A total of 164 preterm neonates were randomized into facilitated tucking (n ≤ 82) and KMC (n ≤ 82) groups. Pain was assessed using the Neonatal Infant Pain Scale (NIPS), and physiological parameters were recorded. Statistical analysis was performed using Student’s t-test, with p < 0.05 considered significant. Mean NIPS scores were significantly lower in the facilitated tucking group (1.9 ± 0.7) compared to the KMC group (3.2 ± 0.9) (p ≤ 0.004). A greater proportion of neonates experienced no pain in the facilitated tucking group (52.4%) compared to KMC (35.3%). No significant differences were observed in physiological parameters. Facilitated tucking is more effective than KMC in alleviating vaccination-related pain in preterm neonates and can be recommended as a routine non-pharmacological intervention in NICUs.