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Learning Objective 1: The learner will be able to understand the effect of skin-to-skin contact on lowering cry time in full-term neonates during and after injection.
Learning Objective 2: The learner will be able to understand the effect of skin-to-skin contact on lowering cry time in preterm neonates during and after heel-stick.
Crying is a common response to pain in preterm and full-term neonates. Skin-to-skin contact, in which a mother holds her diaper clad neonate skin-to-skin on her chest, is an intervention which effectively minimizes a neonate’s cry response to pain.
Methods:
The first study was a randomized controlled trial which included 36 healthy full-term neonates aged birth to 2 days old, conducted to investigate the effects of skin-to-skin contact on cry time during and after hepatitis B vaccine intramuscular injection. Neonates were randomly assigned to two groups: Intervention, skin-to-skin contact (n = 17) and Control, standard care (n = 19). Cry time was continuously tape recorded before, during and after the injection.
Results:
During injection, intervention neonates had a mean cry time of 23 seconds compared to 32 seconds for controls. During recovery, intervention neonates had a mean cry time of 16 seconds compared to 72 seconds for controls.
Methods:
The second study which included 10 preterm neonates aged 2 to 9 days old was a prospective randomized cross-over study to investigate the effects of skin-to-skin contact on cry time during and after heel-sticks. Infants were randomly assigned to two sequences A and B. Sequence A, day 1 the neonate was given the heel stick while being held skin-to-skin and day 2 the same neonate had heel-stick while in incubator on standard care, sequence B reversed sequence A. Neonates were videotaped before, during, and after heel-sticks. Cry times were scored from videotapes.
Results:
When in Skin-to-skin was compared with incubator, cry time was less during (p = .001) and after (p = .01) heel-sticks.
Conclusion:
Skin- to-skin contact is effective intervention on reducing cry response to painful procedures in preterm and full-term neonates. Across nations, recommendations and guidelines are needed to provide safe application of this intervention for neonatal painl.
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