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Nurs Womens Health. 2019 Feb;23(1):59-70. doi: 10.1016/j.nwh.2018.11.002. Epub 2018 Dec 25.

Physiology of Stress and Use of Skin-to-Skin Care as a Stress-Reducing Intervention in the NICU.


Advances in neonatal care have allowed for the increasing survival of critically ill infants. These infants experience significant stress related to painful procedures and physical separation from their parents. The purpose of this article is to describe the physiologic stress mechanisms that contribute to mortality and morbidity in infants in the NICU and the physiologic mechanisms by which skin-to-skin care (SSC) acts on the stress response system. Findings from current literature supporting the use of SSC and barriers and facilitators to implementation are reviewed. SSC is a safe and effective intervention to reduce stress for infants and their parents. Nurses play a key role in facilitating SSC to optimize outcomes of care in the NICU.


NICU; kangaroo care; neonatal intensive care unit; pain; skin-to-skin; stress


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