Skin contact affects babies’ pain response

Skin to skin contact between a parent and newborn baby reduces the infant’s response to pain, a new study has found.

Writing in the latest edition of the European Journal of Pain Joint, researchers at UCL, UK, and York University, Canada, found there was more activity in newborn babies’ brains when they reacted to a heel lance when a parent was holding them through clothing, than without clothing.

Senior author Dr Lorenzo Fabrizi, of UCL Neuroscience, Physiology & Pharmacology, said: “We have found when a baby is held by their parent, with skin-on-skin contact, the higher level brain processing in response to pain is somewhat dampened. The baby’s brain is also using a different pathway to process its response to pain.

“While we cannot confirm whether the baby actually feels less pain, our findings reinforce the important role of touch between parents and their newborn babies.”

The study involved 27 newborns, from 0 to 96 days old, both premature and term age who were delivered at University College London Hospitals.

The researchers measured their responses to the heel lance by recording brain activity with electroencephalography electrodes placed on the scalp.

The babies were split into three groups: held by their mother skin-to-skin, held by their mother with clothing, or they lay in a cot or incubator and were in the main swaddled.

The researchers found that the initial brain response to the pain was the same. However, the heel lance elicited four to five waves of brain activity – and the later waves of activity were impacted by whether the baby was held skin to skin or with clothing.

Joint senior author Professor Rebecca Pillai Riddell, of the Department of Psychology, York University, Canada, said: “The slightly delayed response was dampened if there was skin contact with their mother, which suggests that parental touch impacts the brain’s higher level processing. The pain might be the same, but how the baby’s brain processes and reacts to that pain depends on their contact with a parent.

“Our findings support the notion that holding a newborn baby against your skin is important to their development.”

The brains of the babies that remained in the cot or incubator also reacted less strongly to the pain than those held in clothing, but the researchers say that may be because the babies were not disrupted by being picked up before the procedure, or else due to the success of the sensitive, individualised care they were provided.

The researchers also found that the babies’ brain responses were not only dampened in the skin-to-skin group, but also followed a different neural pathway.

Dr Laura Jones, first author of UCL Neuroscience, Physiology & Pharmacology, said: “Newborn babies’ brains have a high degree of plasticity, particularly those born preterm, and their development is highly dependent on interactions with their parents. Our findings may lend new insights into how babies learn to process threats, as they are particularly sensitive to maternal cues.”

Co-author Dr Judith Meek from University College London Hospitals added: “Parents and clinicians have known for many years how important skin to skin care is for babies in NICU. Now we have been able to demonstrate that this has a solid neurophysiological basis, which is an exciting discovery.”

Jones L, Laudiano-Dray M-P, Whitehead K et al. The impact of parental contact upon cortical noxious-related activity in human neonates. European Journal of Pain 24 September 2020; doi: 10.1002/ejp.1656.

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