Medical Professional Publications

Infants Discharged From NICUs Have a Reduced Neurological Response to Touch

Columbus, OH — April 2017

Touch – and the somatosensory system in general – provides the “scaffolding” for development of other sensory systems in an infant’s very early life. A recent study led by a physician-researcher at Nationwide Children’s Hospital gives new insight into how that scaffolding is altered when a baby is born preterm and experiences painful procedures in the hospital.

The research also serves to emphasize the importance of supportive touch, such as parental holding, skin-to-skin contact and physical and occupational therapy, in caring for these infants.   

The study, published in Current Biology, reveals that babies born preterm have a reduced neurological response to gentle touch compared to babies born full term. It also shows that painful procedures may negatively affect neurological processing of non-painful touch.

“There is often an assumption that we can tell what a baby is perceiving based on vital signs or facial expressions, and our team wanted to go beyond that,” said Nathalie Maitre, MD, PhD, member of the Division of Neonatology at Nationwide Children’s, principal investigator in the hospital’s Center for Perinatal Research and lead author of the study. “What we found in doing that has important clinical applications.”

Dr. Maitre and her colleagues used soft-net electroencephalography to measure event-related potentials in 55 full-term babies and 61 preterm babies (with a range of gestational ages of 24-36 weeks). Researchers used a puff of air as a stimulus. They also measured brain responses to a “sham” stimulus, or a puff of air that was directed away from the baby.

Preterm infants displayed cortical responses to gentle touch over a certain time frame that were of significantly lower amplitude than infants born full term. The decrease in touch response was proportional to the degree of prematurity at birth. There was no reduction found in response to the sham stimulus.

The researchers then examined the number of painful and supportive touches experienced by infants in a neonatal intensive care unit, and those experiences’ relationship to touch response. Noiceptive exposures – including surgeries, line insertions, injections and other experiences – were associated with decreased cortical response when controlling for gestational age and postnatal days. Supportive touches were associated with increased response to gentle touch.

“Related studies show that analgesics and sucrose do not necessarily counteract painful procedures, so it absolutely essential to minimize the exposure to them that infants experience during hospitalization,” says Dr. Maitre, who is also an associate professor of Pediatrics at The Ohio State University College of Medicine. “An emphasis on non-pharmacological treatments for pain and strategies such as kangaroo care is crucial.”

Reference:
Maitre NL, Key AP, Chorna OD, Slaughter JC, Matusz PJ, Wallace MT, Murray MM. The dual nature of early-life experience on somatosensory processing in the human infant brain. Current Biology.  2017 March 15. [Epub ahead of print]

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