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Skin-to-Skin Contact: An Intervention for Reducing
Neonatal Pain
Merisa AkuszewskiAzusa Pacific University
The Importance of Managing Neonatal Pain• Infants encounter painful stimuli as a result
of routine medical procedures
• Because of their undeveloped pain-inhibiting pathways, infants experience more pain during painful procedures than children and adults do
• Unrelieved pain in infants can lead to decreased pain tolerance in adulthood
(Cong et al., 2012; Esfahani et al., 2013)
The Importance of Managing Neonatal PainMany medications
are useful in treating pain, but are associated with adverse side effects
It is important to determine non-pharmacological interventions
Skin-to-Skin ContactSkin-to-skin contact (SSC)
is achieved when an unclothed infant is placed on its mother's bare chest
Benefits of SSC:Accelerates brain
developmentImproves oxygenationTemperature regulationStimulates digestion and
weight gainStrengthens bond between
parent and infant
Davidson, London, & Ladewig, 2012; Phillips, 2013)
Skin-to-Skin Contact Reduces Infants’ Autonomic Pain Responses
Infants' who received SSC had:
More stable heart rates throughout the procedures
Cried for shorter periods of time
Lower mean pain scores
(Chermont, et al., 2009; Cong et al., 2012; Esfahani et al., 2013; Kostandy, Anderson, & Good, 2013; Razek & El-Dein,
2009)
Skin-to-Skin Contact is More Effective than Other Interventions
SSC is superior to other non-pharmacological interventions at reducing neonatal pain
Infants who received SSC reached relaxed behavioral states more quickly compared to infants who received no intervention, massage therapy or an oral sweetener.
(Chermont, et al., 2009; Esfahani et al., 2013; Kostandy et al., 2013)
Breastfeeding
Breastfeeding reduced infants' pain, cry time, and increased heart rate stability.
(Esfahani et al., 2013; Razek & El-Dein, 2009)
Implementing Skin-to-Skin Contact into Nursing Practice
SSC should be implemented into nursing practice as a standard hospital protocol for labor and delivery and neonatal intensive care units (NICU).
Breastfeeding should be used as the primary intervention for infants undergoing painful procedures
Basic SSC should be used as a secondary or replacement therapy
(Chermont, et al., 2009; Cong et al., 2012; Esfahani et al., 2013; Kostandy et al., 2013; Razek & El-Dein, 2009)
Implementing Skin-to-Skin Contact into Nursing Practice
Educate and motivate nursing staff
Educate parents/families
Provide privacy and space
Using Breastfeeding to Reduce Infants’ Pain During Immunization
https://www.youtube.com/watch?v=8Wzjxvrl91U
(Children’s Hospital of Eastern Ontario, 2013)
ReferencesChermont, A.G., Falcão, L., Silva, E., Balda, R., & Guinsburg, R. (2009). Skin-to-skin contact
and/or 25% oral dextrose for procedural pain relief for term newborn infants. Pediatrics, 124(6), 1101-1107. doi: 10.1542/peds.2009-0993
Children’s Hospital of Eastern Ontario. [Cheovideos]. (2013, October 21). Baby vaccination; the secret to a calm and peaceful immunization [Video file]. Retrieved from https://www.youtube.com/watch?v=8Wzjxvrl91U
Cong, X., Cusson, R. M., Walsh, S., Hussain, N., Ludington-Hoe, S. M., & Zhang, D. (2012). Effects of skin-to-skin contact on autonomic pain responses in preterm infants. The Journal of Pain, 13(7), 636-645. doi: 10.1016/j.jpain.201202008
Davidson, M., London, M., & Ladewig, P. (2012). Old's maternal-newborn nursing & women's health across the lifespan. Upper Saddle River, NJ: Pearson.
Esfahani, M. S., Sheykhi, S., Abdeyazdan, Z., Jodakee, M., & Boroumandfar, K. (2013). A comparative study on vaccination pain in the methods of massage therapy and mothers' breast feeding during injection of infants referring to Navabsafavi Health Care Center in Isfahan. Iranian Journal of Nursing and Midwifery Research, 18(6), 494-498.
Kostandy, R., Anderson, G. C., & Good, M. (2013) Skin-to-skin contact diminishes pain from hepatitis B vaccine injection in healthy full-term neonates. Neonatal Network: Journal of Neonatal Nursing, 32(4), 274-280. doi: 10.1891/0730-0832.32.4274
Phillips, R. (2013). Uninterrupted skin-to-skin contact immediately after birth. Newborn and Infant Nursing Reviews, 13 (2), 67-72.
Razek, A. A., & El-Dein, N. A. Z. (2009). Effect of breast-feeding on pain relief during infant immunization injections. International Journal of Nursing Practice, 15, 99-104. doi: 10.1111/j.1440-172X.2009.01728.x