title: 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.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
authors.affiliation: Department of Pediatrics, NICU, Drammen Hospital, Norway; Vestre Viken Hospital Trust, Norway. Electronic address: Lene.Tandle@Vestreviken.no.
authors.forename: Lene Tandle
authors.initials: LT
authors.lastname: Lyngstad
authors.affiliation: Department of Pediatrics, NICU, Drammen Hospital, Norway; Vestre Viken Hospital Trust, Norway.
authors.forename: Bente Silnes
authors.initials: BS
authors.lastname: Tandberg
authors.affiliation: The Skills Simulation Center, Medical Faculty, University of Oslo, Institute for Clinical Medicine, Oslo, Norway.
authors.forename: Hanne
authors.initials: H
authors.lastname: Storm
authors.affiliation: Department of Pediatrics, NICU, Drammen Hospital, Norway; Vestre Viken Hospital Trust, Norway.
authors.forename: Birgitte Lenes
authors.initials: BL
authors.lastname: Ekeberg
authors.affiliation: Department of Pediatrics, NICU, Drammen Hospital, Norway; Vestre Viken Hospital Trust, Norway.
authors.forename: Atle
authors.initials: A
authors.lastname: Moen
mesh_terms: D018592:Cross-Over Studies; D041381:Diapers, Infant; D005260:Female; D005712:Galvanic Skin Response; D006339:Heart Rate; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D060127:Kangaroo-Mother Care Method; D008297:Male; D010101:Oxygen Consumption; D010865:Pilot Projects; D013315:Stress, Psychological / Q000503:physiopathology / Q000628:therapy*; D014110:Touch
keywords: Diaper change; Kangaroo Mother Care; NICU; Preterm infant; Routine care giving tasks; Skin-to-skin contact; Stress