Grant: Operating Grant

Preterm infants in the neonatal intensive care unit (NICU) undergo many procedures that are needed, but may be painful; if not managed effectively, pain has negative effects on the brain and on long-term development. Medications used to treat pain have significant negative side effects. Instead, behavioral treatments are recommended. Skin-to-skin holding by parents is one of the most effective treatments reducing pain by as much as 50%. Consistent use of skin-to-skin holding can reduce hospital stay by 20%. However, parents may not be available 24 hours/day and some babies are too medically fragile to be held. To address this problem, we have developed a device called Calmer (US Provisional Patent #61762411), which interacts beneficially with the infant to reduce pain. In a small pilot study (n=10), infants on Calmer had 50% less pain than infants given the standard care, and had 88% better heart rate regulation (a sign of reduced stress) when they were lying at rest in their beds. For this research, we will test an upgraded model of Calmer in a group of 80 preterm infants born between 27 -36 weeks gestational age. We will compare the effects of Calmer with those of standard treatment, facilitated tucking, for reducing pain during a routine blood test. We will also examine work flow for NICU staff, evaluate Calmer durability, and how infants stress levels respond if they remain on Calmer for 8 hours. Finally, we will conduct 2 NICU staff focus groups, and 8-10 individual parent interviews to gather suggested improvements to the Calmer design, staff views on work flow, and general experiences and acceptance. With regular use, Calmer may reduce pain, reduce hospital length of stay saving taxpayers 20% in health care costs, and improve the long-term health and well-being of Canadian infants.