Leg massage reduces pain associated with heel stick, a blood-drawing method for infants, according to research from the University of Calgary and Foothills Medical Center, both in Alberta, Canada.

In the study, “Prior leg massage decreases pain responses to heel stick in preterm babies,” pain behaviors and physiological changes were observed in infants who required blood sampling.

In this randomized, double-blind, crossover trial, 23 preterm infants were assigned to receive massage or no-massage treatment before a blood sample was taken from the heel. The process was repeated on a second occasion with treatment groups switching treatments, and each infant served as his or her own control.

On the first sampling, infants in the experimental group received massage to the outer aspect of the leg chosen for the heel stick five minutes before the blood sample was collected. The massage consisted of slow strokes from toes to mid thigh by using a firm but gentle pressure by fingers and thumbs. At the end of the two-minute massage, the heel was wrapped with a warm cloth for two to three minutes. The control group received no massage. On the second sampling, two to seven days later, the groups received opposite treatments.

Pain responses were assessed using the Neonatal Infant Pain Scale (NIPS) and by measuring heart rate, respiratory rate, oxygen saturation, and serum cortisol levels before and after the heel stick. After the heel stick, NIPS and heart rate significantly increased in the no-massage group compared with the massage group. Respiratory rate, oxygen saturation and serum cortisol were not significantly different.

The authors state that leg massage may work “by ‘closing the gate’ or by activating the endogenous opioid pathway to decrease nociceptive transmission of pain associated with heel stick.” They conclude that massage is safe since it causes no adverse responses and seems to decrease pain responses in babies.

Source: University of Calgary and Foothills Medical Center, Alberta, Canada. Authors: Sunil Jain, Praveen Kumar and Douglas D. McMillan. Originally published in Journal of Paediatrics and Child Health, Vol. 42, No. 9, September 2006, pp. 505–508.

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