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

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.