Is a nappy change stressful to neonates?

Early Human Development
Evalotte MöreliusNina Nelson

Abstract

Infants in neonatal intensive care (NICU infants) are often cared for in a stressful environment that includes potentially painful or stressful interventions. The aim was to investigate whether NICU infants have different pattern of stress and pain responses than healthy newborns when challenged by a non-painful everyday care routine. NICU infants born at 23-38 weeks gestation (n=39) were compared to healthy full-term newborns (n=30). Cortisol concentrations in saliva were determined before and 30 min after a standardised nappy change. The premature infant pain profile (PIPP) and the neonatal infant pain scale (NIPS) were evaluated before, during, directly after, 3 min after, and 30 min after the nappy change. The investigation was performed on two different occasions, first between postnatal days 2-7 and then between postnatal days 10-18. NICU infants had higher median baseline salivary cortisol levels compared to full-term newborns on both occasions (17.1 nmol/L vs. 6.2 nmol/L p<0.01 and 8.5 nmol/L vs. 2.4 nmol/L p<0.01, respectively). Salivary cortisol decreased in response to the second nappy change in NICU infants (p=0.01). NICU infants had higher PIPP scores during both nappy changes (p<0.001 for both occasions) and more ...Continue Reading

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