Neonatal Experience of Social Touch (NEST)
Research type
Research Study
Full title
The Healing Power of Touch: Investigation of a peripheral neurological mechanism for reducing pain and enhancing neurodevelopmental outcomes.
IRAS ID
291417
Contact name
Susannah Walker
Contact email
Sponsor organisation
Liverpool John Moores University
Clinicaltrials.gov Identifier
Duration of Study in the UK
0 years, 8 months, 30 days
Research summary
Summary of Research
New-born infants are subject to several painful experiences that cause physiological, biochemical and behavioural indicators of stress, with preterm infants often receiving up to 15 painful stimuli daily e.g., heel-lance, venepuncture. Despite the development of infant pain assessment tools and various non-clinical interventions, significant challenges remain. Although the impact of seemingly insignificant procedures may not be immediately apparent, when new-born's experience a stressor the developing brain releases high levels of the stress hormone, cortisol, resulting in insulin resistance, defects in the immune system, and destructive changes in brain structures. Additional long-term consequences to repeated infant pain include alteration of later pain response, delayed postnatal growth, poor early neurodevelopment, with potential for permanently altered brain development.
Sucrose is the most commonplace analgesic; however, concerns highlighted in a systematic review suggest a need for research to provide an alternative solution.While other touch-based, non-pharmacological interventions are recommended, no dynamic touch intervention are included in clinical practice guidelines. We have recently shown that gentle dynamic touch interventions lower pre-term infants respiratory heart rate/increase blood oxygenation levels, and significantly reduced pain measures in term infants undergoing painful procedures. There is potential to develop a simple non-pharmacological intervention which can be delivered by parents or caregivers to provide neuroprotective developmentally supportive care, can easily be adopted into clinical settings and incurs no cost with exception to training.
The study will be conducted at Liverpool Women’s Hospital, all infants who meet the inclusion criteria will be eligible to participate. One group of infants will receive a gentle touch intervention before a clinically relevant painful procedure, the control group will receive care as usual. The entire testing period is expected to take 45 minutes to an hour; however, we anticipate piloting the study with five infants prior to commencing the main study.
Summary of Results
Infants in neonatal units often undergo multiple medical procedures each day, which can be stressful. This research aimed to assess whether a brief, gentle touch intervention could be incorporated into routine clinical care to help alleviate these responses. This study tested whether gentle stroking, administered immediately before a routine painful procedure reduced markers of stress in neonates receiving care in a low-dependency neonatal ward.With parental consent, eligible infants were randomly assigned to one of two groups: one group received ten seconds of gentle stroking to their leg before a medically required blood sample. The other group received standard care before their blood sample was taken. Stress levels were measured using heart rate and cortisol (a hormonal marker of stress).
Infants who received gentle stroking had lower levels of cortisol and a lower heart rate following the blood sample, compared to the standard care group. Although the sample size was small and further research is needed to confirm these results, the findings support the potential of gentle stroking as a simple, low-cost intervention that may reduce stress during routine neonatal care.
The results of this study will be included in the researcher’s PhD thesis. Families who participated will be informed of the findings and may be presented at conferences and/or published in a medical journal. We are grateful to the families who contributed to this research.
REC name
West of Scotland REC 4
REC reference
21/WS/0077
Date of REC Opinion
20 Aug 2021
REC opinion
Further Information Favourable Opinion