The Effect of the Facilitated Tucking after Vaginal Delivery on Stress, Comfort, and Physiological Parameters of Late Preterm: A Randomized Control Trial

Document Type : Original Article


1 Department of Nursing, Yusuf Serefoglu Faculty of Health Sciences, Kilis 7 Aralık University, Kilis, Turkey

2 Department of Nursing, Faculty of Health Sciences, Usak University, Usak, Turkey


Background: Vaginal delivery may cause stress for all newborns; therefore, it is the responsibility of nurses to provide physiologic stability and first care of the preterm after birth. This study aimed to examine the effect of facilitated tucking (FT) after vaginal deliveries on stress, comfort, and physiologic parameters of late preterm infants.
Methods: This randomized controlled study was conducted with late preterm infants. The sample size was calculated using a computer program. A total of 60 preterm infants were included in the study, assigned to the FT group (n=30) and the control group (n=30). A newborn information and registration form, the Newborn Comfort Behavior Scale (NCBS), and the Newborn Stress Scale (NSS) were used to collect data.
Results: The mean NSS score was lower in the FT group and preterm infants showed less stress symptoms; however, the difference was not significant. The mean NCBS score was statistically significantly lower in the FT group, showing that the preterm babies were more comfortable in this group.
Conclusion: It was determined that FT, which is one of the individualized developmental care practices, provides physiologic stability, comfort, and reduced stress for late preterm infants after vaginal deliveries.


  1. Schiavenato M, Holsti L. Defining procedural distress in the NICU and what can be done about it. Neonatal Netw. 2017;36(1):12-17.
  2. Cirik VA, Efe E. The effect of expressed breast milk, swaddling and facilitated tucking methods in reducing the pain caused by orogastric tube insertion in preterm infants: a randomized controlled trial. Int J Nurs Stud. 2020;104:103532.
  3. Taplak AS, Bayat M. Comparison the effect of breast milk smell, white noise and facilitated tucking applied to Turkish preterm infants during endotracheal suctioning on pain and physiological parameters. J Pediatr Nurs. 2021;56:e19-26.
  4. Peng HF, Yin T, Yang L, Wang C, Chang YC, Jeng MJ, et al. Non-nutritive sucking, oral breast milk, and facilitated tucking relieve preterm infant pain during heel-stick procedures: A prospective, randomized controlled trial. Int J Nurs Stud. 2018;77:162-70.
  5. Liu Y, Huang X, Luo B, Peng W. Effects of combined oral sucrose and nonnutritive sucking (NNS) on procedural pain of NICU newborns, 2001 to 2016: A PRISMA-compliant systematic review and meta-analysis. Medicine. 2017;96(6):
  6. Avcin E, Kucukoglu S. The effect of breastfeeding, kangaroo care, and facilitated tucking positioning in reducing the pain during heel stick in neonates. J Pediatr Nurs. 2021;61:410-16.
  7. Erkut Z, Yildiz S. The effect of swaddling on pain, vital signs, and crying duration during heel lance in newborns. Pain Manag Nurs. 2017;18(5):328-36.
  8. Kostandy RR, Ludington‐Hoe SM. The evolution of the science of kangaroo (mother) care (skin‐to‐skin contact). Birth Defects Res. 2019;111(15):1032-43.
  9. Kucukoglu S, Kurt S, Aytekin A. The effect of the facilitated tucking position in reducing vaccination-induced pain in newborns. Ital J Pediatr. 2015;41:1-7.
  10. Yin T, Yang L, Lee TY, Li CC, Hua YM, Liaw JJ. Development of a traumatic heel-stick procedures by combined treatment with non-nutritive sucking, oral sucrose, and facilitated tucking: a randomized, controlled trial. Int J Nurs Stud. 2015;52(8):1288-99.
  11. Gautheyrou L, Durand S, Jourdes E, De Jonckheere J, Combes C, Cambonie G. Facilitated tucking during early neonatologist‐performed echocardiography in very preterm neonates. Acta Paediatr. 2018; 107(12):2079-85.
  12. Ranjbar A, Bernstein C, Shariat M, Ranjbar H. Comparison of facilitated tucking and oral dextrose in reducing the pain of heel stick in preterm infants: a Randomized Clinical Trial. BMC Pediatr. 2020;20:1-9.
  13. Ambuel B, Hamlett KW, Marx CM, Blumer JL. Assessing distress in pediatric intensive care environments: the COMFORT scale. J Pediatr Psychol. 1998;17(1):95-109.
  14. Van Dijk M, Roofthooft DW, Anand KJ, Guldemond F, de Graaf J, Simons S, et al. Taking up the challenge of measuring prolonged pain in (premature) neonates: the COMFORTneo scale seems promising. Clin J Pain. 2009;25(7):607-16.
  15. Kahraman A, Basbakkal Z, Yalaz M. Reliability and validity tests of comfortneo scale in Turkish. IJNS. 2014;1(2):1-11.
  16. Ceylan SS, Bolışık B. Examining psychometric properties of newborn stress scale. AUHSJ. 2017;2:97-103.
  17. Valizadeh L, Ghahremani G, Mostafa Gharehbaghi M, Asghari Jafarabadi M, Rahkar Farshi M. Effects of facilitated tucking on duration and frequency of crying during rest among hospitalized premature infants: A randomized clinical trial. Int J Pediatr. 2018;6(4):7543-52.
  18. Lopez O, Subramanian P, Rahmat N, Theam LC, Chinna K, Rosli R. The effect of facilitated tucking on procedural pain control among premature babies. J Clin Nurs. 2015;24(1-2):183-91.
  19. Salmani N, Dehghani K, Sadeghnia A. Effect of facilitated tucking created with simulated hands on physiological pain indicators during venipuncture in premature infants. Iran J Neonatol. 2017;8(4):7-12.
  20. SchulzKF, Altman DG, Moher D. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. Journal of Pharmacology and pharmacotherapeutics. 2010;1(2):100-7.