Skin to Skin Contact Reduces Infant Pain

A Mother's Breast Means More Than Milk

As reported on baby gooroo

A team of Brazilian researchers recently explored the use of skin-to-skin contact and/or concentrated sugar water (dextrose) for pain relief in newborns during procedures such as a heel stick or an injection.

The effects of skin-to-skin contact were previously summarized by Moore and colleagues in 2006. Previous evidence exists for Sucrose alone as an effective measure for alleviating pain, but whether a combination of the two measures is more effective than either by itself has not been investigated .

Methods

A total of 640 healthy, term babies 12-to-72-hours of age participated in the study. Babies scheduled to receive an injection of hepatitis B vaccine were randomly assigned to one of four groups:

• Group one received standard care which consisted of 1ml of water placed on the tip of the tongue 2 minutes prior to the injection.
• Group two received 1ml of 25% dextrose solution (concentrated sugar water) placed on the tip of the tongue 2 minutes prior to the injection.
• Group three received continuous skin-to-skin contact starting 2 minutes prior to the injection and continuing throughout the procedure.
• Group four received both the sugar water and continuous skin to skin contact.

Neonatal Facial Coding System and Neonatal Infant Pain Scale scores were measured in all babies prior to the procedure, during thigh cleansing, during the injection, and 2 minutes after the injection.

Results

Babies who received sugar water or continuous skin-to-skin contact experienced less pain compared to those who received plain water. However, babies who received sugar water and continuous skin-to-skin contact experienced the least amount of pain. The combination of the two methods of pain relief was more effective than either method alone.

The researchers theorized that the beneficial effect of skin-to-skin contact is likely due to multisensory stimulation in which the touch and smell of the mother and the sound of her heartbeat block nerve transmission. Another possibility is that the sensory stimulation triggers the release of endorphins or peptides, substances produced in the body that have pain-relieving properties similar to narcotics.

The Bottom Line

Mothers and fathers should be encouraged to hold their babies skin-to-skin whenever possible especially during painful procedures. In addition, parents should talk with their baby’s health care provider about giving the child a sugar solution prior to any painful procedure.

Previous research found that breastfeeding in addition to the use of sugar water did not improve pain relief. However, more research is needed to determine how the relief achieved with skin-to-skin contact and sugar water compares to that of skin-to-skin contact and breastfeeding.