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Effect of Nesting During Intramuscular Injection on Pain, Stress, and Breastfeeding Success in Cesarean-Born Term Newborns (NESTING)

2 sierpnia 2026 zaktualizowane przez: Emine Nur Çalımlı Celep, Istanbul University - Cerrahpasa

The Effect of Nesting Practice on Pain, Stress Level, and Breastfeeding Success During Intramuscular Injection in Term Newborns Delivered by Cesarean Section

This randomized controlled trial aims to evaluate the effect of nesting during the first intramuscular injection on pain, stress level, physiological parameters, settling time, and breastfeeding success in healthy term newborns delivered by cesarean section. A total of 112 newborns will be randomly assigned in a 1:1 ratio to either a nesting intervention group or a routine care control group. Newborns in the intervention group will receive nesting until the first intramuscular injection, whereas those in the control group will receive routine neonatal care. Pain, stress level, physiological parameters, settling time, and breastfeeding success will be evaluated using validated assessment tools. The findings are expected to provide evidence regarding the effectiveness of nesting as a simple, safe, and non-pharmacological intervention for reducing procedural pain and stress in newborns while supporting breastfeeding success.

Przegląd badań

Status

Rekrutacyjny

Warunki

Interwencja / Leczenie

Szczegółowy opis

Painful procedures performed during the first hours after birth, particularly intramuscular vitamin K and hepatitis B injections, are associated with significant pain and stress responses in newborns. Although several non-pharmacological interventions have been recommended to minimize procedural pain, evidence regarding the effectiveness of nesting in healthy term newborns delivered by cesarean section remains limited.

This study is designed as a prospective, single-center, parallel-group, randomized controlled trial. The study will be conducted in the newborn observation room of the Delivery Unit at Kocaeli Darıca Farabi Training and Research Hospital. Healthy term newborns (37-42 weeks of gestation) delivered by cesarean section will be enrolled after written informed parental consent is obtained. A total of 112 newborns will be randomly allocated in a 1:1 ratio to either the nesting intervention group or the routine care control group using Random Allocation Software.

Newborns assigned to the intervention group will be placed in a sterile cotton nesting position until the first intramuscular injection. Routine intramuscular administration of vitamin K and hepatitis B vaccine will be performed according to standard neonatal care. The control group will receive routine neonatal care without nesting. No additional invasive procedures will be performed for research purposes.

Pain, stress level, heart rate, respiratory rate, oxygen saturation, and settling time will be assessed before, during, and one minute after the injection. Breastfeeding success will be evaluated at the first breastfeeding after mother-infant reunion, at one hour after breastfeeding, and before hospital discharge using validated assessment tools. Outcome assessment will be performed by an independent assessor who is blinded to group allocation.

The primary objective of this study is to determine whether nesting reduces procedural pain and stress while improving physiological stability and breastfeeding success in term newborns delivered by cesarean section. The results are expected to contribute to evidence-based neonatal care by supporting the implementation of developmental, non-pharmacological interventions during routine newborn procedures.

Typ studiów

Interwencyjne

Zapisy (Szacowany)

112

Faza

  • Nie dotyczy

Kontakty i lokalizacje

Ta sekcja zawiera dane kontaktowe osób prowadzących badanie oraz informacje o tym, gdzie badanie jest przeprowadzane.

Kontakt w sprawie studiów

Kopia zapasowa kontaktu do badania

Lokalizacje studiów

    • Kocaeli
      • Darıca, Kocaeli, Turcja (Türkiye)
        • Rekrutacyjny
        • Kocaeli Darıca Farabi Training and Research Hospital
        • Kontakt:
        • Główny śledczy:
          • Sevil İnal, Prof. Dr.
        • Pod-śledczy:
          • Emine Nur Çalımlı Celep, Msc
        • Pod-śledczy:
          • Yasemin Dinçel, Msc

Kryteria uczestnictwa

Badacze szukają osób, które pasują do określonego opisu, zwanego kryteriami kwalifikacyjnymi. Niektóre przykłady tych kryteriów to ogólny stan zdrowia danej osoby lub wcześniejsze leczenie.

Kryteria kwalifikacji

Wiek uprawniający do nauki

  • Dziecko

Akceptuje zdrowych ochotników

Tak

Opis

Inclusion Criteria:

  • Written informed consent was obtained from the parent(s) or legal guardian(s) of the newborn.
  • Born by cesarean section.
  • Term newborn (gestational age between 37+0 and 41+6 weeks).
  • Birth weight between 2,500 g and 4,000 g.
  • Clinically stable vital signs (including heart rate, respiratory rate, and oxygen saturation).
  • No acute or chronic medical conditions.
  • No congenital anomalies.
  • No requirement for endotracheal intubation, resuscitation, or admission to the neonatal intensive care unit (NICU).
  • Scheduled to receive the first intramuscular injection after birth.

Exclusion Criteria:

  • Multiple birth (e.g., twins or higher-order multiples).
  • Administration of vitamin K or hepatitis B vaccine before completion of the study procedures.
  • Withdrawal of parental consent at any time during the study.
  • Use of a pacifier, oral sucrose, or any pharmacological or non-pharmacological pain-relief intervention before completion of the outcome assessments.
  • Discharge from the hospital or transfer to another healthcare facility before completion of the study procedures.
  • Delayed mother-newborn reunion due to maternal general anesthesia or prolonged sedation following spinal or epidural anesthesia.
  • Delayed transfer of the newborn to the mother because of prolonged surgery, intraoperative complications, or delayed postoperative stabilization.

Plan studiów

Ta sekcja zawiera szczegółowe informacje na temat planu badania, w tym sposób zaprojektowania badania i jego pomiary.

Jak projektuje się badanie?

Szczegóły projektu

  • Główny cel: Leczenie podtrzymujące
  • Przydział: Randomizowane
  • Model interwencyjny: Przydział równoległy
  • Maskowanie: Podwójnie

Broń i interwencje

Grupa uczestników / Arm
Interwencja / Leczenie
Eksperymentalny: Nesting Group
Term newborns delivered by cesarean section will receive the nesting intervention before and during routine intramuscular injection. Pain, stress level, and breastfeeding success will be assessed using validated outcome measures.
Nesting is a non-pharmacological positioning intervention in which the newborn is placed in a flexed, midline posture using rolled towels or positioning supports to provide containment before and during intramuscular injection. The intervention aims to reduce procedural pain and stress and improve breastfeeding success.
Brak interwencji: Standard Care Group
Term newborns delivered by cesarean section will receive routine care during intramuscular injection without the nesting intervention. Pain, stress level, and breastfeeding success will be assessed using the same outcome measures.

Co mierzy badanie?

Podstawowe miary wyniku

Miara wyniku
Opis środka
Ramy czasowe
Neonatal Pain
Ramy czasowe: Immediately before intramuscular injection, during intramuscular injection, and 1 minute after intramuscular injection.
Pain will be assessed using the Neonatal Pain, Agitation and Sedation Scale (N-PASS). The pain/agitation component consists of five behavioral and physiological indicators, each scored from 0 to 2, yielding a total score ranging from 0 to 10. Higher scores indicate greater pain.
Immediately before intramuscular injection, during intramuscular injection, and 1 minute after intramuscular injection.
Neonatal Stress Level
Ramy czasowe: Immediately before intramuscular injection, during intramuscular injection, and 1 minute after intramuscular injection.
Neonatal stress will be assessed using the Neonatal Stress Scale. The scale consists of eight behavioral and physiological indicators, each scored from 0 to 2, yielding a total score ranging from 0 to 16. Higher scores indicate greater neonatal stress.
Immediately before intramuscular injection, during intramuscular injection, and 1 minute after intramuscular injection.

Miary wyników drugorzędnych

Miara wyniku
Opis środka
Ramy czasowe
Heart Rate
Ramy czasowe: Immediately before intramuscular injection, during intramuscular injection, and 1 minute after intramuscular injection.
Heart rate will be measured in beats per minute (bpm) to evaluate the newborn's physiological response to intramuscular injection. Higher heart rate values indicate a greater physiological response to procedural stress.
Immediately before intramuscular injection, during intramuscular injection, and 1 minute after intramuscular injection.
Respiratory Rate
Ramy czasowe: Immediately before intramuscular injection, during intramuscular injection, and 1 minute after intramuscular injection.
Respiratory rate will be measured in breaths per minute (breaths/min) to evaluate the newborn's physiological response to intramuscular injection. Higher respiratory rate values indicate a greater physiological response to procedural stress.
Immediately before intramuscular injection, during intramuscular injection, and 1 minute after intramuscular injection.
Peripheral Oxygen Saturation
Ramy czasowe: Immediately before intramuscular injection, during intramuscular injection, and 1 minute after intramuscular injection.
Peripheral oxygen saturation (SpO₂) will be measured using pulse oximetry and reported as a percentage (%) to evaluate the newborn's physiological response to intramuscular injection. Higher SpO₂ values indicate better oxygenation.
Immediately before intramuscular injection, during intramuscular injection, and 1 minute after intramuscular injection.
Breastfeeding Success
Ramy czasowe: At the first breastfeeding following mother-newborn reunion, 1 hour after the first breastfeeding, and 48 hours after birth (prior to hospital discharge).
Breastfeeding success will be assessed using the Bristol Breastfeeding Assessment Tool (BBAT). The BBAT consists of four items (positioning, attachment, sucking, and swallowing), each scored from 0 to 2. Total scores range from 0 to 8, with higher scores indicating better breastfeeding effectiveness.
At the first breastfeeding following mother-newborn reunion, 1 hour after the first breastfeeding, and 48 hours after birth (prior to hospital discharge).

Współpracownicy i badacze

Tutaj znajdziesz osoby i organizacje zaangażowane w to badanie.

Sponsor

Śledczy

  • Główny śledczy: Sevil İnal, Prof. Dr., Istanbul University-Cerrahpasa, Department of Midwifery

Daty zapisu na studia

Daty te śledzą postęp w przesyłaniu rekordów badań i podsumowań wyników do ClinicalTrials.gov. Zapisy badań i zgłoszone wyniki są przeglądane przez National Library of Medicine (NLM), aby upewnić się, że spełniają określone standardy kontroli jakości, zanim zostaną opublikowane na publicznej stronie internetowej.

Główne daty studiów

Rozpoczęcie studiów (Rzeczywisty)

15 października 2025

Zakończenie podstawowe (Szacowany)

15 października 2026

Ukończenie studiów (Szacowany)

15 października 2026

Daty rejestracji na studia

Pierwszy przesłany

8 lipca 2026

Pierwszy przesłany, który spełnia kryteria kontroli jakości

2 sierpnia 2026

Pierwszy wysłany (Rzeczywisty)

5 sierpnia 2026

Aktualizacje rekordów badań

Ostatnia wysłana aktualizacja (Rzeczywisty)

5 sierpnia 2026

Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości

2 sierpnia 2026

Ostatnia weryfikacja

1 sierpnia 2026

Więcej informacji

Terminy związane z tym badaniem

Inne numery identyfikacyjne badania

  • NESTING-2025-09

Plan dla danych uczestnika indywidualnego (IPD)

Planujesz udostępniać dane poszczególnych uczestników (IPD)?

NIE

Informacje o lekach i urządzeniach, dokumenty badawcze

Bada produkt leczniczy regulowany przez amerykańską FDA

Nie

Bada produkt urządzenia regulowany przez amerykańską FDA

Nie

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