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Is a nappy change stressful to neonates?

Morelius, Evalotte ; Hellström-Westas, Lena LU ; Carlen, Catarina ; Norman, Elisabeth LU and Nelson, Nina (2006) In Early Human Development 82(10). p.669-676
Abstract
Objectives: 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. Methods: NICU infants born at 23-38 weeks gestation (n=39) were compared to healthy fullterm 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... (More)
Objectives: 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. Methods: NICU infants born at 23-38 weeks gestation (n=39) were compared to healthy fullterm 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. Results: 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 sustained increases in PIPP and NIPS up to 30 min after the nappy changes compared to full-term newborns. Conclusions: NICU infants have higher baseline salivary cortisol than healthy full-term newborns. There is a change in baseline cortisol. by age in both groups. Full.-term infants as well as NICU infants show an increased pain response to a standardised nappy change. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
pain measurement, neonatal intensive care, newborn, cortisol, infant, stress
in
Early Human Development
volume
82
issue
10
pages
669 - 676
publisher
Elsevier
external identifiers
  • wos:000242195600006
  • scopus:33748036440
ISSN
1872-6232
DOI
10.1016/j.earlhumdev.2005.12.013
language
English
LU publication?
yes
id
9aa75587-7cc8-4a6a-8a41-6cd52a1286a6 (old id 376633)
date added to LUP
2016-04-01 17:00:33
date last changed
2020-06-17 02:56:28
@article{9aa75587-7cc8-4a6a-8a41-6cd52a1286a6,
  abstract     = {Objectives: 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. Methods: NICU infants born at 23-38 weeks gestation (n=39) were compared to healthy fullterm 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. Results: 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 &lt; 0.01 and 8.5 nmoL/L vs. 2.4 nmoL/L p &lt; 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 &lt; 0.001 for both occasions) and more sustained increases in PIPP and NIPS up to 30 min after the nappy changes compared to full-term newborns. Conclusions: NICU infants have higher baseline salivary cortisol than healthy full-term newborns. There is a change in baseline cortisol. by age in both groups. Full.-term infants as well as NICU infants show an increased pain response to a standardised nappy change.},
  author       = {Morelius, Evalotte and Hellström-Westas, Lena and Carlen, Catarina and Norman, Elisabeth and Nelson, Nina},
  issn         = {1872-6232},
  language     = {eng},
  number       = {10},
  pages        = {669--676},
  publisher    = {Elsevier},
  series       = {Early Human Development},
  title        = {Is a nappy change stressful to neonates?},
  url          = {http://dx.doi.org/10.1016/j.earlhumdev.2005.12.013},
  doi          = {10.1016/j.earlhumdev.2005.12.013},
  volume       = {82},
  year         = {2006},
}