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STRESS AND INFANCY. Debra Bendell. STRESSFUL PROCEDURES IN THE NICU. Tiffany Field. Invasive procedures and handling have been associated with in...
STRESS AND INFANCY. Debra Bendell. STRESSFUL PROCEDURES IN THE NICU. Tiffany Field. Invasive procedures and handling have been associated with increased heart rate and decreases in TcPO Z in preterm neonates treated in the NICU. Stressful responses to heelsticks and neonatal behavior assessments are reported here. Ina study on the heelstick procedure crying, heart rate and respiration were monitored prior to, during and after heelsticks in minimal care and intensive care preterm neonates. Half of the 96 infants were given pacifiers to alleviate stress during the heelstick procedure. Significant elevations were noted for all 3 measures in all infants during and following heelsticks, but the increases were attenuated for those minimal care neonates receiving pacifiers,and crying was attenuated in intensive care neonates receiving pacifiers. These results suggest that behavioral and physiological stress responses can be alleviated by nonnutritive sucking during invasive procedures such as heelsticks. In the study on neonatal behavior assessments (NBAS) growth hormone levels were monitored in minimal care preterm neonates. Although increases in growth hormone occur · following stress in children and adults, decreases in growth hormone have been associated with stre~sful procedu~es in neonates. As compared to baseline, growth hormone levels were significantly 9iminished following neonatal behavior assessments in minimal care preterm neonates, suggesting that handling during behavior assessments may be stressful for the immature neonate. These results are discussed in the context of individual, immaturity and intervention differences in response to stressful neonatal procedures.