Survival rates of preterm infants have increased with advancements in technology and a growing awareness of the importance of prenatal, intrapartum, and postnatal monitoring and care (Kapoor et al., 2021). While these improvements represent a major achievement in neonatal care, the rise in survival rates has also led to an increased exposure of preterm infants to numerous painful procedures during hospitalization (Rogers et al., 2023). Due to the immaturity of the autonomic nervous system—which plays a critical role in neurodevelopment, behavior, and cognitive function—preterm infants are particularly vulnerable to stress and painful stimuli (Schneider et al., 2018). Painful interventions in this population may result in short-term complications such as bradycardia or tachycardia, tachypnea, increased blood pressure, and elevated intracranial pressure; more importantly, repeated pain exposure may lead to long-term adverse outcomes, including learning difficulties and neurodevelopmental impairments (Wang et al., 2022; Wang et al., 2023).

The sense of touch begins to develop in humans during the fifth week of intrauterine life and remains one of the most mature sensory systems after birth, particularly in preterm infants. This early maturation highlights the potential of tactile-based interventions in neonatal pain management. Accordingly, in recent years, tactile stimulation has been increasingly utilized as a non-pharmacological method to alleviate pain during invasive procedures (Çağlar et al., 2025; Fadlalmola et al., 2023).

Kangaroo Mother Care (KMC), also referred to as skin-to-skin contact, provides infants with a warm and secure environment, supports mother–infant bonding, prevents hypothermia, reduces the length of hospital stay, and promotes stabilization of physiological parameters (Choirunisa et al., 2021; Saptaputra et al., 2021). Beyond these well-established benefits, recent evidence suggests that KMC inhibits pain transmission by stimulating the vestibular system through maternal heartbeat, scent, and voice. This multisensory stimulation contributes to the inactivation of the hypothalamic–pituitary–adrenal (HPA) axis and activation of the limbic cortex, thereby reducing pain perception. Consequently, KMC has become a frequently preferred non-pharmacological method during invasive procedures in neonatal care settings (Ghaemmaghami et al., 2024; Johnston et al., 2017; Wang et al., 2022; Zhao et al., 2022).

Among therapeutic touch methods, the Gentle Human Touch (GHT) technique is a delicate tactile stimulation approach in which one hand is placed on the infant's crown and the other on the abdominal region without applying massage (Dur et al., 2020). By providing continuous, gentle human touch, this technique calms the infant, prevents the transmission of pain signals to the cerebral cortex, and helps reduce pain perception (Fadlalmola et al., 2023). Previous studies have demonstrated that the GHT technique is effective in reducing pain and stabilizing physiological parameters in preterm infants during aspiration procedures (Çağlar et al., 2024; Fatollahzade et al., 2022), retinopathy of prematurity (ROP) examinations (Sun et al., 2020), and other invasive interventions (Kılınç & Çağlar, 2025; Sezer Efe et al., 2022).

In addition to tactile interventions, the presence of parents during painful procedures has been recognized as an important component of family-centered care. Evidence indicates that parental presence reduces anxiety in both infants and family members, alleviates pain levels, and accelerates the healing process (Gil Mayo et al., 2022; Kılınç & Çağlar, 2025; Lin et al., 2020; Ullsten et al., 2024).

The number of studies examining the effects of individual non-pharmacological interventions on pain management in preterm infants has increased. Some of these studies have focused on Kangaroo Mother Care (KMC), others on the Gentle Human Touch (GHT) technique, and others on parental presence. However, these interventions have mostly been addressed separately, and studies evaluating their comparative effectiveness remain insufficient. In addition, the majority of existing studies have examined the application of the GHT technique by healthcare professionals, while evidence regarding its implementation by mothers remains limited.

This randomized controlled experimental study was conducted to determine the effects of maternal GHT and KMC practices during intravenous blood sampling on preterm infants' pain scores, crying duration, and physiological parameters (peak heart rate and oxygen saturation).