Abstract
Background Rooming-in practice improves breastfeeding and reduces newborn stress reactivity. When this modality is not available, partial rooming-in after birth can be considered. Salivary cortisol levels (SCLs) are considered reliable biomarkers to indicate stress. Objective To test the hypothesis that rooming-in duration impacts neonatal stress response in hospitalized newborns. Design/methods Forty term newborns, enrolled in the Neonatology and Obstetrics Nursing, C.G. Ruesch, Naples, Italy, were divided, according to the mother's choice, into the study (SG; n = 20) and control (CG; n = 20) groups if they received full (24 hs) or partial (14 hs) rooming-in care, respectively. Saliva samples were collected from all babies between 7:00 a.m. and 8:00 a.m. of the 3rd day of life by using oral swab. Salivary cortisol levels were measured using an enzyme immunoassay kit (Salimetrics LLC, PA, USA). Results A statistically significant difference in the SCLs between SG and CG was found (median: 258 ng/dl versus 488.5 ng/dl; p = 0.048). Conclusions Data support the practice of full rooming-in care compared with partial rooming-in. The rooming-in duration clearly reduces SCLs and likely neonatal stress. These lower SCLs may have long-term positive effects reducing the risk of metabolic syndrome, high blood pressure, and cognitive and behavioural changes.
Highlights
According to clinical managements, newborns are often exposed to painful and stressful situations
Grunau et al and Miller and Ferriero investigated whether neonatal procedural pain/stress impacts the developing brain, discovering that greater exposure to procedural pain-related stress was associated with reduced development of white matter and subcortical gray matter [2, 3]
The sampling of saliva obtained on the 3rd day of life revealed that Salivary cortisol levels (SCLs) were lower in the study group than in the control group (Table 1)
Summary
Newborns are often exposed to painful and stressful situations. When the infant faces up to a stressful situation, the developing hypothalamic-pituitary-adrenal axis is activated: the hypothalamus secretes the corticotropin-releasing hormone, which starts the release of adrenocorticotropic hormone by the pituitary gland This hormone induces, in the adrenal gland cortex, the secretion of glucocorticoids as cortisol, considered a stress indicator hormone since its plasma levels will be high as a result of the psychological and physical stress response [5]. Rooming-in practice improves breastfeeding and reduces newborn stress reactivity When this modality is not available, partial rooming-in after birth can be considered. The rooming-in duration clearly reduces SCLs and likely neonatal stress These lower SCLs may have long-term positive effects reducing the risk of metabolic syndrome, high blood pressure, and cognitive and behavioural changes
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