Extremely Preterm Infants and the Effects of Skin-to-skin Contact During the First Weeks of Life
Rationale: Ragnhild Maastrup and Gorm Greisen are two neonatal specialists from the University of Copenhagen in Copenhagen, Denmark. There had been research done about the effects of skin-to-skin contact on premature infants, but no research had been done about extremely preterm infants and the effects of skin-to skin contact. The difference between preterm infants and extremely preterm infants is that extremely preterm infants have a more immature temperature regulation, less subcutaneous fat, and more permeable skin which results in a higher rate of evaporative heat loss. Masstrup and Greisen hypothesized that when transfers (from incubator to parent’s chest) are optimized, the extremely preterm infants will keep adequate temperatures while they are skin-to skin with their parents and the infants will not become more unstable.
Patients and Methods: Extremely preterm infants are defined as infants born before 28 weeks of gestation and skin-to skin contact was defined as the infant- dressed in only a diaper and a hat-on the parent’s bare chest. From March to December 2008, 57 extremely preterm infants were admitted to the NICU at the University Hospital. For 22 of the infants, a researcher was not available, 11 infants were too unstable to be studied, and two infants died. This left 22 infants who were able to be studied. Two of the participating infants died after the study in deaths that were not related to the study. None of the parents of the infants refused to let their infant participate.
The temperature of the infants was maintained in their incubator for two hours before the skin-to-skin contact (pre-test). Then, skin-to-skin contact was initiated (test). The skin-to-skin contact lasted from 51 minutes at the shortest to 6.5 hours at the longest. The average time of skin-to-skin contact was 98 minutes. The infants’ temperatures were taken during the skin-to-skin contact and then the infants’ temperatures were regulated for 2 hours once back in the incubator (post-test). The temperatures of the infants were taken continuously from the beginning of the pre-test to the end of the post-test at one minute intervals. The infants’ heart rates, respiration rates, and oxygen saturation were monitored electronically.
In order to standardize the transfers from incubator to chest, and to prevent the most amount of heat loss, a blanket with plastic was placed in the incubator and the infants wore blankets during the transfer.
Results: The temperature of the infants stayed constant through the pre-test, test, and the post-test. The mean skin temperature decreased in two infants and increased in one infant. The majority of the infants’ temperatures stayed constant and regular through the experiment.
Discussion: The hypothesis was proven to be correct. This coincides with another study done on infants born before 27 weeks of gestation who had a mean age of three days. This study differs from a study done with infants born before 28 weeks of gestation and studied the differences on skin-to-skin contact in the first week of life verses the second week of life.
In general, the temperature of the infants decreased more when they were skin-to-skin with the father. But other studies have found no difference in the temperature based on if the infant is with its father or mother. This finding must then be attributed to other possible variables.
Reflection: We found this study to be very interesting, especially as we have been studying haptics in class. It is amazing to see how body heat and skin-to-skin contact can help maintain body temperature. Also, from watching medical shows, both fictional and non-fictional I have seen many times that skin-to-skin contact between infants (both pre and full term) helps them to thrive in their new environment outside of the womb. Also, the skin-to-skin contact helps with the bonding between the parents and their newborn. We would guess that skin-to-skin contact between the father and the newborn would help even more with the bonding process because obviously fathers do not get the experience of breastfeeding like the mother does.
Application: We will always remember the effects of skin-to-skin contact and body temperature. This concept could be used in any situation where a person needs to be warmed up. Maybe one day our car gets stuck in the middle of nowhere in a snowstorm. We would not want to keep the car running so to keep warm we would use the concept of skin-to-skin contact. This concept can even be taken further to say that in Genesis 2:18 “The LORD God said, ‘It is not good for man to be alone…’”. We all need to rely on others for love, help, and companionship. The skin-to-skin contact between parents and their newborn child is just one illustration of this passage.
Patients and Methods: Extremely preterm infants are defined as infants born before 28 weeks of gestation and skin-to skin contact was defined as the infant- dressed in only a diaper and a hat-on the parent’s bare chest. From March to December 2008, 57 extremely preterm infants were admitted to the NICU at the University Hospital. For 22 of the infants, a researcher was not available, 11 infants were too unstable to be studied, and two infants died. This left 22 infants who were able to be studied. Two of the participating infants died after the study in deaths that were not related to the study. None of the parents of the infants refused to let their infant participate.
The temperature of the infants was maintained in their incubator for two hours before the skin-to-skin contact (pre-test). Then, skin-to-skin contact was initiated (test). The skin-to-skin contact lasted from 51 minutes at the shortest to 6.5 hours at the longest. The average time of skin-to-skin contact was 98 minutes. The infants’ temperatures were taken during the skin-to-skin contact and then the infants’ temperatures were regulated for 2 hours once back in the incubator (post-test). The temperatures of the infants were taken continuously from the beginning of the pre-test to the end of the post-test at one minute intervals. The infants’ heart rates, respiration rates, and oxygen saturation were monitored electronically.
In order to standardize the transfers from incubator to chest, and to prevent the most amount of heat loss, a blanket with plastic was placed in the incubator and the infants wore blankets during the transfer.
Results: The temperature of the infants stayed constant through the pre-test, test, and the post-test. The mean skin temperature decreased in two infants and increased in one infant. The majority of the infants’ temperatures stayed constant and regular through the experiment.
Discussion: The hypothesis was proven to be correct. This coincides with another study done on infants born before 27 weeks of gestation who had a mean age of three days. This study differs from a study done with infants born before 28 weeks of gestation and studied the differences on skin-to-skin contact in the first week of life verses the second week of life.
In general, the temperature of the infants decreased more when they were skin-to-skin with the father. But other studies have found no difference in the temperature based on if the infant is with its father or mother. This finding must then be attributed to other possible variables.
Reflection: We found this study to be very interesting, especially as we have been studying haptics in class. It is amazing to see how body heat and skin-to-skin contact can help maintain body temperature. Also, from watching medical shows, both fictional and non-fictional I have seen many times that skin-to-skin contact between infants (both pre and full term) helps them to thrive in their new environment outside of the womb. Also, the skin-to-skin contact helps with the bonding between the parents and their newborn. We would guess that skin-to-skin contact between the father and the newborn would help even more with the bonding process because obviously fathers do not get the experience of breastfeeding like the mother does.
Application: We will always remember the effects of skin-to-skin contact and body temperature. This concept could be used in any situation where a person needs to be warmed up. Maybe one day our car gets stuck in the middle of nowhere in a snowstorm. We would not want to keep the car running so to keep warm we would use the concept of skin-to-skin contact. This concept can even be taken further to say that in Genesis 2:18 “The LORD God said, ‘It is not good for man to be alone…’”. We all need to rely on others for love, help, and companionship. The skin-to-skin contact between parents and their newborn child is just one illustration of this passage.