Does skin-to-skin contact reduce stress during diaper change in preterm infants?

Abstract

Background: Skin-to-skin contact reduces pain response in preterm infants subjected to minor painful procedures, such as heel lance. Diaper change is a procedure performed several times daily in hospitalized preterm infants. Routine care giving tasks such as diaper change may be stressful for the infant.

Aims: The purpose of this study was to investigate whether diaper change induces stress and if skin-to-skin contact could reduce such stress, measured by changes in skin conductance.

Study design: This was a randomized crossover pilot study in 19 preterm infants with gestational age between 28 and 34 weeks. The diaper change procedure was done twice in each infant, once during skin-to-skin contact, and once in incubator or bed with the mother present.

Outcome measures: During diaper change heart rate (HR), peripheral oxygen saturation (SpO2), and changes in skin conductance (SC) peaks per sec, using the Skin Conductance Algesimeter (SCA), were registered.

Results: The mean SC peaks/sec increased/decreased significantly under/after change of diapers which thereby underpins that this is a stressful procedure for the preterm infant. Skin-to-skin contact (SSC) entails significantly lower stress levels (p<0.05) compared to diaper changed in an incubator/bed measured by the SCA.

Conclusions: Diaper change is a stressful procedure for preterm infants and may be ameliorated by skin-to-skin contact.

Keywords: Diaper change; Kangaroo Mother Care; NICU; Preterm infant; Routine care giving tasks; Skin-to-skin contact; Stress.