Systematic review of the effects of skin-to-skin care on short-term physiologic stress outcomes in preterm infants in the neonatal intensive care unit

Hospitalization in the neonatal intensive care unit (NICU) exposes infants to many different stressors. There is increasing evidence that chronic stress early in life can have long-term impacts on health. Skin-to-skin care (SSC) is an intervention that can be used to reduce stress in the NICU. In this review of the literature, we found that current research suggests that SSC improves short-term cardiorespiratory stress outcomes compared with incubator care. There is strong evidence that SSC reduces cortisol and increases oxytocin levels in preterm infants. Additional research is needed on timing of initiation, duration, and frequency of SSC to optimize the stress-reducing benefits.

Authors: Britt Pados & Francis Hess

Publication Information: Advances in Neonatal Care. 2020; 20(1): 48-58. doi: 10.1097/ANC.0000000000000596

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Heart rate variability as a feeding intervention outcome measure in the preterm infant

In this study, we explored the use of heart rate variability (HRV) as a measure of stress in infants during feeding. HRV was compared between usual care feeding and feeding with a gentle, coregulated (CoReg) approach. In the 14 preterm infants in this study, we found that infants fed using the CoReg approach had fewer apneic events and higher RR (they were able to breathe more during feeding). Infants fed using the usual care approach had significantly higher SD12, a measure of HRV indicating randomness in the heart rate, which has been found to be a measure of physiologic stress in other populations. Further research on HRV as an intervention outcome measure is needed. SD12 may be a more sensitive indictor than other physiologic outcomes.

Authors: Britt Pados, Suzanne Thoyre, George Knafl, & Brant Nix

Publication Information: Advances in Neonatal Care. 2017; 17(5): E10-E20. doi: 10.1097/ANC.0000000000000430

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