Skin to Skin Contact for Just 1 Hour Evidence Significant Decrease in NICU Infant Stress

Findings from Oxidative Stress Biomarker Decreased in Preterm Neonates Treated With Kangaroo Mother Care are described by the author and PTBi researcher, Dr. Dorothy Forde. Additional authors include Douglas D. Deming, John C. Tan, Raylene M. Phillips, Eileen K. Fry-Bowers, Mary K. Barger, Khaled Bahjri, Danilyn M. Angeles, and Danilo S. Boskovic.

Please describe your research findings.

We provide preliminary evidence that kangaroo mother care (KMC) intervention also known as skin-to-skin contact (SSC) may reduce neonatal stress and lower inflammatory tone overtime for the preterm infant. KMC provides a buffer to stress by increasing parent-interaction in order to decrease the negative effects of short-term stress from painful and noxious procedures which can be on average of 10-14 times per day. High amounts of stress that is unrelieved by parental buffering can have long-term neurodevelopmental problems over the infant’s life span.  We now know from our study, that after just one more hour of KMC between incubator care and KMC babies, stress levels measured through urinary allantoin significantly decreased.

What is important about the study?

This is the first study to link biochemical markers to the physiologic benefits shown in previous research studies that support SSC.

What is already known about this topic, and how do your findings add to or change this existing knowledge?

Strong evidence from both experimental and observational research shows that KMC improves short-term stress outcomes compared to incubator care. KMC is shown to reduce both parent and infant stress and should be an integral stress-reducing intervention. Our study results support the practice of early KMC intervention in the NICU, with the ultimate goal of reducing stress and promoting the health and well-being of preterm infants.

How does your research impact current clinical practice? How does your research impact patients?

Experimental studies show that prolonged separation of mother and infant is not optimal for infant or mother. The separation necessary for medical care of very sick or preterm infants can be lifesaving, but infants experience unintended stressors that are often consequences of necessary techniques in the NICU. We are aware that chronic stress from repeated painful experiences early in life can result in structural and functional changes in the brain that can contribute to lifelong neurodevelopmental and behavioral problems in children.  In clinical practice, we currently have no clear understanding of the ideal timing for KMC or what the duration of KMC should be on any given day, or what the frequency of KMC should be in order to optimize these stress-reducing effects. We now know from our study, higher doses of sustained KMC for at least 1-hour yield lower stress benefits and decrease the inflammatory tone of infants in the NICU.

What should researchers/providers/patients/public health workers/etc. do as a result of these findings?

KMC should be considered an essential part to providing optimal care in the NICU. Neonatal nurses/physicians should facilitate early, often, and sustained duration of KMC in all NICU populations in order to optimize the stress-reducing effects unless KMC intervention is medically contraindicated.

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Oxidative Stress Biomarker Decreased in Preterm Neonates Treated With Kangaroo Mother Care