The Impact of Holding on Stress and Bonding in Mother-Infant Pairs During Therapeutic Hypothermia
| Status: | Recruiting |
|---|---|
| Conditions: | Hospital, Neurology |
| Therapuetic Areas: | Neurology, Other |
| Healthy: | No |
| Age Range: | Any |
| Updated: | 2/14/2019 |
| Start Date: | December 4, 2018 |
| End Date: | July 2019 |
| Contact: | Leah H Fox, MD |
| Email: | lfox@mmc.org |
| Phone: | 207-662-2405 |
The Impact of Holding During Therapeutic Hypothermia on Saliva Oxytocin and Cortisol Levels in Mother-Infant Pairs
This research is being done to try to improve the experience of mothers and babies during
therapeutic hypothermia. Currently, mothers are not able to hold their baby during
hypothermia treatment. Mothers have reported that not being able to hold their baby during
this time is stressful. Additionally, it is known that holding has many benefits for mothers'
and babies' psychological and physical health.
Therapeutic hypothermia is the standard of care. The experimental interventions of this study
are to have mothers hold their babies during this treatment, collect saliva samples from
mothers and babies, and test the saliva samples for the hormones cortisol and oxytocin. The
investigators will test saliva of infants and their mothers before and after holding. The
investigators hope to demonstrate decreased cortisol, a marker for stress, and increased
oxytocin, a marker for bonding, in infants and mothers while they are held during therapeutic
hypothermia.
therapeutic hypothermia. Currently, mothers are not able to hold their baby during
hypothermia treatment. Mothers have reported that not being able to hold their baby during
this time is stressful. Additionally, it is known that holding has many benefits for mothers'
and babies' psychological and physical health.
Therapeutic hypothermia is the standard of care. The experimental interventions of this study
are to have mothers hold their babies during this treatment, collect saliva samples from
mothers and babies, and test the saliva samples for the hormones cortisol and oxytocin. The
investigators will test saliva of infants and their mothers before and after holding. The
investigators hope to demonstrate decreased cortisol, a marker for stress, and increased
oxytocin, a marker for bonding, in infants and mothers while they are held during therapeutic
hypothermia.
The inability to hold an infant being treated with therapeutic hypothermia in the neonatal
intensive care unit has been subjectively reported by ours and other research groups as a
significant source of stress for parents. The investigators aim to assess the impact of
holding on endocrinological markers of stress and bonding. Specifically, the investigators
plan to collect salivary cortisol and oxytocin levels from infants undergoing therapeutic
hypothermia and their mothers prior to and immediately after a 30-minute holding period.
The investigators hypothesize that measurable increases in salivary oxytocin levels,
coinciding with the reported qualitative increased levels of bonding, will be observed after
the holding period. The investigators anticipate the reported stress reduction after holding
to be quantified by measurable decreases in salivary cortisol levels. The investigators
hypothesize these hormone changes will be present in both the mother and the infant when
compared to samples taken without the holding intervention.
intensive care unit has been subjectively reported by ours and other research groups as a
significant source of stress for parents. The investigators aim to assess the impact of
holding on endocrinological markers of stress and bonding. Specifically, the investigators
plan to collect salivary cortisol and oxytocin levels from infants undergoing therapeutic
hypothermia and their mothers prior to and immediately after a 30-minute holding period.
The investigators hypothesize that measurable increases in salivary oxytocin levels,
coinciding with the reported qualitative increased levels of bonding, will be observed after
the holding period. The investigators anticipate the reported stress reduction after holding
to be quantified by measurable decreases in salivary cortisol levels. The investigators
hypothesize these hormone changes will be present in both the mother and the infant when
compared to samples taken without the holding intervention.
Inclusion Criteria:
- gestational age at birth of 35 weeks or greater
- absence of clinical or electrographic seizures during the first 24 hours of
therapeutic hypothermia
- designation as "clinically stable" by the attending neonatologist on service
- respiratory status of: room air, nasal cannula, continuous positive airway pressure or
intubated on conventional ventilator
Exclusion Criteria:
- designation as "clinically unstable" by the a member of the medical team
- use of inhaled nitric oxide for persistent pulmonary hypertension of the newborn
- high frequency oscillator ventilation
- presence of electrographic seizures
- use of vasopressors or paralytic agents, presence of chest tubes, wound vacuums, or
drains
- in utero opiate exposure
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