Grant: Doctoral Research Award: Canada Graduate Scholarships

Approximately 10% of infants are born preterm every year, many of whom spend a significant amount of time in the Neonatal Intensive Care Unit (NICU) and are exposed to daily painful procedures as a result. Skin-breaking procedures during NICU stays have been shown to alter brain structure and functioning, contributing to negative physical and psychological outcomes in both the short- and long-term. It is critical to identify the factors that shape, and mitigate, neonatal acute pain. A recent collaborative observational study by our lab showed that caregiver holding in skin-to skin (bare chested caregiver holding diaper clad infant) during a heel lance was associated with lower brain responses in hospitalized infants. It was shown that holding a baby clothed during heel lance resulted in the highest pain response. The proposed experimental randomized controlled trial attempts to better understand the impact of caregiver holding on infant brain, heart rate, and facial responses to pain. Importantly, the study also seeks to understand why skin-to-skin holding may protect against the effect of pain on the brain by examining whether parent heart rate before and during the heel lance and infant heart rate before plays a role. I believe that parental physiological arousal (heart rate) may be impacting the efficacy of skin to skin holding, as infants are right on the chest and lower parental arousal will result in infant having lower heart rate before and during heel lance. By further understanding the differential impact of various caregiver holding styles on infant pain responding as well as the mechanisms, this study has the potential to shape standard practice for involving parents in their infants' NICU care to optimize outcomes.