Does skin-to-skin contact reduce stress during diaper change in preterm infants?

Background: Skin-to-skin contact reduces pain response in preterm infants subjected to minor painful procedures, such as heel lance. Diaper change is a procedure performed several times daily in hospitalized preterm infants. Routine care giving tasks such as diaper change may be stressful for the infant. Aims: The purpose of this study was to investigate whether diaper change induces stress and if skin-to-skin contact could reduce such stress, measured by changes in skin conductance. Study design: This was a randomized crossover pilot study in 19 preterm infants with gestational age between 28 and 34 weeks. The diaper change procedure was done twice in each infant, once during skin-to-skin contact, and once in incubator or bed with the mother present. Outcome measures: During diaper change heart rate (HR), peripheral oxygen saturation (SpO(2)), and changes in skin conductance (SC) peaks per sec, using the Skin Conductance Algesimeter (SCA), were registered. Results: The mean SC peaks/sec increased/decreased significantly under/after change of diapers which thereby underpins that this is a stressful procedure for the preterm infant. Skin-to-skin contact (SSC) entails significantly lower stress levels (p < 0.05) compared to diaper changed in an incubator/bed measured by the SCA. Conclusions: Diaper change is a stressful procedure for preterm infants and may be ameliorated by skin-to-skin contact. (c) 2014 Elsevier Ireland Ltd. All rights reserved.