Evaluation of analgesic effect of skin-to-skin contact compared to oral glucose in preterm neonates

Objective An estimation of the individual's ability to cope with environmental adversity, that is, stress resiliency, can be extrapolated by measuring cardiac vagal tone, that is, high-frequency heart rate variability (HF-HRV); indeed, higher HF-HRV is associated with health and developmental advantages for preterm neonates. Previous studies show skin-to-skin contact (SSC) improves stress resiliency; however, linkages between SSC and HF-HRV on outcomes have not been assessed. We aimed to test the hypothesis that increased SSC frequency would enhance HF-HRV, reduce neonatal morbidity, and improve developmental outcomes. Study Design Weekly electrocardiograms and clinical data were obtained from 101 preterm neonates. SSC frequency was determined from the electronic medical record. Results At postnatal week 1, frequency of SSC and HF-HRV were positively correlated (p =.02); further, multiple stepwise regressions showed higher HF-HRV and SSC predicted reduced days on ventilation and oxygen, and shorter hospital stay (p < 0.001). Higher HF-HRV predicted lower postmenstrual age (PMA) at discharge (p < 0.01). Conclusion Higher SSC frequency was associated with increased HF-HRV during the first postnatal week. SSC and HF-HRV uniquely predicted diminished neonatal morbidity throughout hospitalization. Additionally, HF-HRV uniquely predicted earlier PMA at discharge. Augmenting SSC early in life enhances stress resiliency and improves health outcomes.

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Co-bedding of Preterm Newborn Pigs Reduces Necrotizing Enterocolitis Incidence Independent of Vital Functions and Cortisol Levels

Frontiers in Pediatrics ◽

10.3389/fped.2021.636638 ◽

2021 ◽

Vol 9 ◽

Author(s):

Anders Brunse ◽

Yueming Peng ◽

Yanqi Li ◽

Jens Lykkesfeldt ◽

Per Torp Sangild

Keyword(s):

Necrotizing Enterocolitis ◽

Digestive Enzyme ◽

Blood Gases ◽

Preterm Neonates ◽

Clinical Effects ◽

Skin Contact ◽

Vital Functions ◽

Cortisol Levels ◽

Skin To Skin ◽

Cardiovascular Functions

Background: Preterm infants are born with immature organs, leading to morbidities such as necrotizing enterocolitis (NEC), a gut inflammatory disease associated with adverse feeding responses but also hemodynamic and respiratory instability. Skin-to-skin contact including “kangaroo care” may improve infant survival and health via improved vital functions (e.g., pulmonary, cardiovascular) and endocrine influences by adrenal glucocorticoids. Clinical effects of skin-to-skin contact for newborn siblings (“co-bedding”) are not known. Using NEC-susceptible Preterm pigs as models, we hypothesized that co-bedding and exogenous glucocorticoids improve vital functions and NEC resistance.Methods: In experiment 1, cesarean-delivered, formula-fed Preterm pigs were reared in incubators with (co-bedding, COB, n = 30) or without (single-bedding, SIN, n = 29) a sibling until euthanasia and tissue collection on day four. In experiment 2, single-bedded Preterm pigs were treated postnatally with a tapering dose of hydrocortisone (HC, n = 19, 1–3 mg/kg/d) or saline (CON, n = 19).Results: Co-bedding reduced NEC incidence (38 vs. 65%, p < 0.05) and increased the density of colonic goblet cells (+20%, p < 0.05) but had no effect on pulmonary and cardiovascular functions (respiration, blood pressure, heart rate, blood gases) or cortisol levels. There were limited differences in intestinal villous architecture and digestive enzyme activities. In experiment 2, HC treatment increased NEC lesions in the small intestine without any effects on pulmonary or cardiovascular functions.Conclusion: Co-bedding may improve gut function and NEC resistance independently of cardiorespiratory function and cortisol levels, but pharmacological cortisol treatment predispose to NEC. Preterm pigs may be a useful tool to better understand the physiological effects of co-bedding, neonatal stressors and their possible interactions with morbidities in Preterm neonates.

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THE EFFECT OF EARLY SKIN TO SKIN CONTACT IN TERM NEONATES AFTER C-SECTION ON BREASTFEEDING CHOICE AT THE TIME OF DISCHARGE

i-manager’s Journal on Nursing ◽

10.26634/jnur.9.2.15981 ◽

2019 ◽

Vol 9 (2) ◽

pp. 1

Author(s):

POURABOLI BATOOL ◽

ESTABRAGHI MAHDIEH ◽

JAHANI YOUNES ◽

◽

...

Keyword(s):

Term Neonates ◽

Skin Contact ◽

Skin To Skin

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Faculty Opinions recommendation of Analgesia with breastfeeding in addition to skin-to-skin contact during heel prick.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718052154.793483349 ◽

2013 ◽

Author(s):

Laszlo Vutskits

Keyword(s):

Skin Contact ◽

Heel Prick ◽

Skin To Skin

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The Role of Skin-to-Skin Contact and Breastfeeding on Atonic Postpartum Hemorrhage

Nursing Reports ◽

10.3390/nursrep11010001 ◽

2020 ◽

Vol 11 (1) ◽

pp. 1-11

Author(s):

Wedad M. Almutairi ◽

Susan M. Ludington ◽

Mary T. Quinn Griffin ◽

Christopher J. Burant ◽

Ahlam E. Al-Zahrani ◽

...

Keyword(s):

Postpartum Hemorrhage ◽

Retrospective Chart Review ◽

Skin Contact ◽

Labor Duration ◽

Third Stage Of Labor ◽

Estimated Blood Loss ◽

Third Stage ◽

Skin To Skin ◽

Increasing Trends

Objectives: were to (a) determine incidence of postpartum hemorrhage (PPH) in all women delivering between 2009 and 2015, and (b) determine the amount of Estimated Blood Loss (EBL) and duration of the third stage of labor in each subgroup for women with or without PPH, and (c) compare EBL and duration of 3rd stage of labor between subgroups in groups of women with or without PPH. Design: A retrospective chart review conducted using codes for atonic PPH. Setting: Records from a University based tertiary setting, 264 charts were reviewed and data from 154 charts were analyzed. One-way ANOVAs followed with post-hocs and a 2-way ANOVA were conducted. Results: PPH rate increased by 47.50% from 2009–2015. For women with PPH, EBL was lower in skin to skin contact (SSC) + Breastfeeding (BF) subgroup. For women without PPH, EBL was lower in SSC only subgroup. Third stage of labor duration was longer in women with PPH. Conclusions: Study confirmed the increasing trends of PPH due to uterine atony and proposed role of SSC and BF in decreasing EBL and shorten the duration of the 3rd stage of labor for PPH women, usefulness of SSC and BF as physiologic practices merit further study.

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