Blood sampling was performed through a standardized procedure by five experienced nurses, who obtained 5 dried spots of blood collected on a filter paper card. If the sample was not enough to complete all of the dried spots on the filter card, a new heel lance was practiced in few seconds. In this case, neonates were assessed for NIPS measure only after the first heel lance; secondary outcomes were evaluated during the whole sampling. Crying time was defined as the duration of crying while sampling. Percentage of crying was defined as the ratio between crying time while sampling and time of the procedure.