The pain scores of using white noise alone or in combination with the holding were more effective in the regulation of heart rate than the other interventions.

The white noise+holding intervention is the most effective evidence-based practice and non-pharmacologic method for heel stick sampling in newborns.

Although the reduction of pain and regulation of heart rate in the intervention groups were significantly more positively affected than in the control group, there was no significant difference between the groups in terms of oxygen saturation levels.

Heel stick sampling, a common procedure in newborns, causes acute pain.

This study aims to measure the outcome of five various non-pharmacologic pain relief groups; maternal voice, white noise, holding, maternal voice+holding, and white noise+holding.

The study is an open label, randomized controlled trial. A total of 178 newborns were included in this study. Newborns were randomly allocated to each group; white noise (n = 31), maternal voice (n = 31), holding (n = 30), white noise+holding (n = 29), maternal voice+holding (n = 28), and control (n = 29) interventions. Newborns' pain responses were evaluated using the Neonatal Infant Pain Scale (NIPS), and the Premature Infant Pain Profile (PIPP). The primary measured outcomes were the newborns' pain levels, while the secondary outcomes were the heart rate and changes in oxygen saturation. The mean values of pain in neonates between groups were evaluated one minute before (Phase1), during (Phase2), and one minute after (Phase3) the procedure.

The research results are given with comparisons in three time periods (Phase1, Phase2 and Phase3). White noise and white noise+holding were found to have the lowest mean NIPS and PIPP score (p < 0.001). The mean heart rate was found to be the lowest in the white noise+holding group (p < 0.001). There was no significant difference between the groups in terms of oxygen saturation score (p = 0.453).

The white noise+holding applied to newborns during heel stick sampling were effective in pain reduction. Nurses and midwives can use white noise+holding method.

These results contribute to the pain management of newborns.

Acute pain

Heart rate

Infant

Pain management

Oxygen saturation

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