title: The effects of skin-to-skin contact during acute pain in preterm newborns.
abstract: OBJECTIVE
  Several promising non-pharmacological interventions have been developed to reduce acute pain in preterm infants including skin-to-skin contact between a mother and her infant. However, variability in physiological outcomes of existing studies on skin-to-skin makes it difficult to determine treatment effects of this naturalistic approach for the preterm infant. The aim of this study was to test the efficacy of mother and infant skin-to-skin contact during heel prick in premature infants.
  
  
  METHODS
  Fifty nine stable preterm infants (born at least 30 weeks gestational age) who were undergoing routine heel lance were randomly assigned to either 15 min of skin-to-skin contact before, during and following heel prick (n=31, treatment group), or to regular care (n=28, control group). Throughout the heel lance procedure, all infants were assessed for change in facial action (NFCS), behavioral state, crying, and heart rate.
  
  
  RESULTS
  Statistically significant differences were noted between the treatment and control groups during the puncture, heel squeeze and the post phases of heel prick. Infants who received skin-to-skin contact were more likely to show lower NFCS scores throughout the procedure. Both groups of infants cried and showed increased heart rate during puncture and heel squeeze although changes in these measures were less for the treated infants.
  
  
  CONCLUSIONS
  Skin-to-skin contact promoted reduction in behavioral measures and less physiological increase during procedure. It is recommended that skin-to-skin contact be used as a non-pharmacologic intervention to relieve acute pain in stable premature infants born 30 weeks gestational age or older.
authors.affiliation: University of Sao Paulo at Ribeirao Preto College of Nursing, WHO Collaborating Centre for Nursing Research Development, Av. Bandeirantes 3900, Ribeirao Preto-SP, CEP: 14040-902, Brazil. thailacastral@usp.br
authors.forename: Thaila C
authors.initials: TC
authors.lastname: Castral
authors.forename: Fay
authors.initials: F
authors.lastname: Warnock
authors.forename: Adriana M
authors.initials: AM
authors.lastname: Leite
authors.forename: Vanderlei J
authors.initials: VJ
authors.lastname: Haas
authors.forename: Carmen G S
authors.initials: CG
authors.lastname: Scochi
mesh_terms: D000208:Acute Disease; D005260:Female; D006365:Heel; D006801:Humans; D018730:Infant Behavior; D007224:Infant Care / Q000379:methods; D007231:Infant, Newborn; D008297:Male; D016602:Needlestick Injuries; D017283:Neonatal Nursing / Q000379:methods*; D010146:Pain / Q000451:nursing* / Q000517:prevention & control*; D010147:Pain Measurement; D012867:Skin; D014110:Touch