Grant: Project Grant

Approximately 8% of births in Canada are preterm births. During an average Neonatal Intensive Care Unit (NICU) stay, preterm infants experience about 12-17 painful procedures a day. The cumulative burden of this pain has significant long-term implications on their biological, psychological, social, and learning development. One of the most highly recommended non-pharmacological strategies to mitigate NICU infants' pain is skin-to-skin contact. This is where a caregiver holds their diaper-clad infant directly on their bare chest surrounding a painful procedure. However, literature reviews have shown that skin-to-skin contact may not always manage the pain responses of very and extremely preterm infants (less than 32 weeks). Numerous calls have been made in the literature to understand the heterogeneity of responding to skin-to-skin contact. Our past research has shown that when parents' and healthy infants' heart patterns are regulated and attuned (i.e. showing a similar pattern of regulation) during a painful procedure, infants have less pain. Our team hypothesizes that when parents are stressed during skin-to-skin care, they may struggle to regulate their own distress-related heart physiology, and then are less attuned with their preterm infant's heart rate physiology making skin-to-skin care less powerful to reduce pain. This study will examine if there is variability in birthing parents' and preterm infants' regulation attunement after a routine heel lance while in skin-to-skin contact, if this variability is related to parental stress, and if this variability impacts skin-to-skin contact effectiveness for pain in these youngest preterms. This grant will be able to provide important information on the implementation of skin-to-skin contact in very and extremely preterm infants and inform the development of new parental interventions that could improve the effectiveness of skin-to-skin contact for pain in very and extremely preterm infants worldwide.