Skin-to-Skin Contact May Reduce Procedural Pain in Infants
by Cynthia M. Johnson, MA
After your child is born, healthcare professionals perform screening tests and give your child a vitamin K shot, eye drops, and a hepatitis B vaccination. If your child has any health issues, additional procedures may be done. Procedures can be painful to infants and result in crying and irritability. Giving an infant pain medication can pose its own problems. Alternative therapies are being tried to better manage pain in infants. One such example is skin-to-skin contact.
Prior research on skin-to-skin contact and its impact on pain have showed benefit in reducing pain during immunizations. Researchers wanted to determine the effect of skin-to-skin contact on pain from procedures in infants. The study, published in The Cochrane Database of Systematic Reviews, found that skin-to-skin contact appears to reduce procedural pain in infants.
About the Study
The systematic review included 25 randomized trials evaluating the use of skin-to-skin contact in 2,001 infants (1 day to 7 months old) during painful procedures, such as a heel stick, intramuscular injection, vaccination, and tape removal. Skin-to-skin contact, also known as kangaroo care, is laying a naked baby on a parent's (usually the mother) bare chest.
Crying time and heart rate were used to assess pain in the studies. Some of the studies used the Premature Infant Pain Profile. The review found that infants who received skin-to-skin contact had less evidence of pain at 60 and 90 seconds after a painful procedure when compared to infants who did not receive skin-to-skin care. At 2 minutes, there was no difference between providing skin-to-skin contact and not providing skin-to-skin contact. Skin-to-skin care had mixed results on an infant's heart rate.
How Does This Affect You?
A systematic review combines a number of smaller trials to create a larger pool of participants. The larger the pool of participants the more reliable the outcomes are. However, the review is only as reliable as the studies that are included. The trials included in this review did not use the same procedures to evaluate pain nor did they use the same pain assessment techniques. Most of the studies used a heel lance as the procedure, while others used an intramuscular injection or something else. Some of the studies assessed pain by crying time or heart rate, while others used a pain profile. Furthermore, the participants in ranged from premature to full term births and ranged in age from 1 day to 7 months. Infants may react different to pain depending on both factors.
More research could help determine the beneficial duration and frequency of skin-to-skin contact as well as its long-term effects. It would also be helpful to research whether skin-to-skin and clothed contact result in similar findings.
Skin-to-skin contact is a safe method to calm and comfort infants. If your infant is having a procedure that may be painful, talk to your doctor about the possibility of providing your infant with skin-to-skin contact during or after the procedure. In some cases, this may not be possible. Depending on the procedure, your doctor may be able to accommodate this request.
Family Doctor—American Academy of Family Physicians
Healthy Children—American Academy of Pediatrics
Immunizations in children and adolescents. EBSCO DynaMed Plus website. Available at: https://www.dyname.... Updated March 15, 2017. Accessed March 22, 2017.
Johnston C, Campbell-Yes M, et al. Skin-to-skin care for procedural pain in neonates. Cochrane Database Syst Rev. 2017 Feb 16;2:CD008435.
Last reviewed March 2017 by Michael Woods, MD, FAAP
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