Did you know skin-to-skin is more effective at reducing stress than care in an incubator?

Infants in the Neonatal Intensive Care Unit are exposed to many stressors.  Growing evidence suggests that stress in early life can lead to long-term neurodevelopmental consequences.  These NICU stressors are often unintended or necessary medical interventions to keep the infant alive.  It is estimated that infants in the NICU experience 10-14 painful procedures a day, which can reprogram the hypothalamic-pituitary-adrenal axis and change the structural and functional parts of the brain.

Skin-to-Skin is often thought of as a way to improve breastfeeding, growth, neurodevelopment, attachment, bonding, and reduce infection.  But could it reduce stress?  In a 2019 literature review published in 2020, Pados and Hess sought to identify the effects of skin-to-skin care on stress reduction versus incubator care.  They searched PubMed and CINAHL for research articles published from 2000-2018 on the effects of skin-to-skin care on stress in the NICU.  They focused on 19 articles for their systematic review.  Results showed significant support that skin-to-skin care has positive effects on stress outcomes versus incubator care.  Better yet, there were very little negative effects of skin-to-skin reported.

Of course, there are barriers in the NICU to support skin-to-skin holding, but it is our role as neonatal caregivers to be creative, patient care advocates, who support earlier, more frequent, and longer durations of skin-to-skin.  There’s no clear evidence to suggest optimal timing and duration of skin-to-skin for stress reduction, and more research needs to be done in the area. However, we do know our tiniest, sickest, most fragile patients may benefit the most, and we should continue to facilitate skin-to-skin each and every day.

Want to improve your skills with skin-to-skin transfers and change the culture of your NICU?  Learn more about customized education here.

Pados, B., Hess, F. (2020). Systematic Review of the Effects of Skin to Skin Care on Short-term Physiologic Stress Outcomes in Preterm Infants in the Neonatal Intensive Care Unit. Advances in Neonatal Care. 20 (1), 48-58.