Premature babies are separated from their parents at birth so that they can be stabilized and receive life-saving care.  They are exposed to painful procedures, that while necessary, can, and often do, have an impact on their neurological development.  Simply being born prematurely has lifelong consequences and it is believed that 40% of low birth weight preterm newborns will be identified as having unfavorable neurodevelopmental outcomes when compared to their full term peers.  Being separated from their parents for prolonged periods of time impacts the newborn’s stress levels and the addition of tests, clinical practices and procedures, all designed to help stabilize and maintain a premature baby’s health until they can be released from the hospital, can permanently alter the baby’s ability to respond to pain and stress in the future.

It has long been recognized that skin to skin care between a premature baby and their parent can help those babies gain weight, maintain body temperature, tolerate procedures and experience less stress during their NICU stay.  Researchers have now found that newborns who are able to hear the live vocalizations of their parents will respond better to stress, and maintain a more stable body state than those infants who do not have that exposure.  Their parent's voice influences the pain receptors in the newborn and may provide a safe and effective analgesia through the newborn’s endogenous oxytocin production during painful procedures.  The findings were documented in the study, Maternal speech decreases pain scores and increases oxytocin levels in preterm infants during painful procedures, published in the journal Scientific Reports in August, 2021

Researchers discovered that being exposed to the speaking or singing of their parent before, during, and after a painful heel prick procedure helped reduce a newborn’s stress response, as measured by respiration, heart rate and oxygen saturation levels in the infant in addition to oxytocin levels sampled in saliva.  The parent did not touch their newborn, but rather modulated their voice to interact and respond to the infant’s behavior throughout a heel prick process, which was the designated painful procedure.

Three separate conditions were tested, parents singing, parents speaking and without parents present at all.  There was an observed difference in the infants’ stress responses when the parent was singing or speaking compared to the absence of the parent.  There was no observed difference between singing and speaking.  The oxytocin levels of the babies went up, as measured in their saliva, and the cortisol levels were reduced (measured in plasma samples) when their parents’ voices were present during painful procedures.

Childbirth educators and other perinatal professionals may want to share this information with the families in their classes and let them know that they can consider using their voice to help their preterm infant better tolerate medical procedures during their NICU stay.  While this study did not examine the impact of the parent’s voice on stress levels in the full term newborn, families may want to consider employing the same techniques should the need arise.

References

Filippa, M., Monaci, M.G., Spagnuolo, C. et al. Maternal speech decreases pain scores and increases oxytocin levels in preterm infants during painful procedures. Sci Rep 11, 17301 (2021). https://doi.org/10.1038/s41598-021-96840-4

Forde D, Fang ML, Miaskowski C. A Systematic Review of the Effects of Skin-to-Skin Contact on Biomarkers of Stress in Preterm Infants and Parents. Advances in Neonatal Care : Official Journal of the National Association of Neonatal Nurses. 2021 May. DOI: 10.1097/anc.0000000000000905. PMID: 34054011.

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