Having a baby born prematurely can be a harrowing experience for parents: watching your small, fragile newborn go through countless procedures in an intimidating neonatal intensive care unit (NICU), wondering what role you could possibly play in helping your child become happy and healthy.
Historically, the role of parents in this scenario was minimal. But that’s been changing in recent years, informed in no small part by research from the School of Nursing.
Marsha Campbell-Yeo, assistant professor at Dal, clinician scientist and nurse practitioner with the IWK Health Centre, researches how maternal-driven interventions can help improve outcomes for at-risk preterm and full-term infants. Specifically, she investigates how skin-to-skin contact from mothers can help babies better manage pain and stress during procedures like needles or an intravenous injection.
“We’ve shown there’s tremendous benefit in something as simple as having a mother hold her baby skin-to-skin during a procedure — up to 30 per cent reduction in the short-term pain response, as well as improvements in how the newborn regulates that pain,” explains Dr. Campbell-Yeo.
That’s important, as some of these babies will spend months in the NICU, and undergo numerous painful procedures as part of their medical care — sometimes as many as 500 to 1000.
“Repeated exposure to these procedures can lead to changes in how they perceive pain, and how they regulate not just pain but other forms of stress later in life,” she adds. “There’s also new, emerging literature that considers how it can actually change the way their brains develop.”
There appears to be something unique about a mother’s ability to help her baby manage pain. Although the impact isn’t as significant as it is with mothers, Dr. Campbell-Yeo (left) and her colleagues have shown similar pain relieving benefits when skin-to-skin contact is provided by fathers, unrelated women, and even a twin. Most of her research has looked at the tiniest and most fragile babies, but healthy children also benefit from being close to their mother.
“All babies experience pain,” says Dr. Campbell-Yeo. “With changes in immunization practices, children now undergo up to 20 injections in the first few years of life. Given that up to one in 10 older children and adults now have needle fear, minimizing routine pain associated with these procedures may help with larger problems down the road.”
Leading a paradigm shift
Dr. Campbell-Yeo and her team are currently finishing up a systematic review of 18 clinical trials around the world — many done at the IWK Health Centre — supporting the role of mothers in pain management of newborns. They’re also starting a new set of clinical trials, funded by the Canadian Institutes of Health Research, investigating the long-term impacts of these interventions.
To an outsider, this may all seem self-evident: wouldn’t it be obvious that babies benefit from close contact with their mothers? But this is a change from the NICUs of the past, with their predominant focus on technology. The IWK Health Centre has been at the forefront of the shift towards family-focused treatment for at-risk newborns, and Dr. Campbell-Yeo and her team continue to work with practicing clinicians and health-care providers to better support babies’ healthy growth.
“This is really a paradigm shift that we’re working towards, and it needs strong, rigorous science to support it,” says Dr. Campbell-Yeo. “What we’re hoping that our latest trial shows is not just that contact with moms is not just nice for babies — it’s necessary.”
For more about research in the School of Nursing, visit its website.
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