“mPINC” is the name of the Centers for Disease Control’s (CDC) survey of hospital maternity care practices regarding infant feeding. The letters mPINC stand for Maternity Practices in Infant Nutrition and Care. Each year since 2007 delivering hospitals have had the opportunity to participate in this survey and benchmark their practices against other hospitals across the country. Survey questions address practices which have been shown by research to improve breastfeeding outcomes.
Memorial Hospital of South Bend received a 69 out of a possible 100 on the most recent mPINC survey. Our efforts toward Baby-Friendly designation will improve our scores, as will care practices we are implementing immediately, such as performing routine procedures skin-to-skin.
This week, Jamie Detwiler, a Mother-Baby Unit nurse, describes her experience and the research behind having parents hold their babies for painful procedures.
In my experience as a registered nurse specializing in maternity care, and as a mother myself, I believe mothers have an innate desire to comfort their children. It is difficult for parents to hear their newborn infant cry; whether their infant’s cries are for something basic, like food, or the result of a pain-inflicting procedure, such as an injection.
Skin-to-skin during a painful procedure can have counteracting benefits on pain, and is a well-tolerated alternative to pharmacological interventions for pain prevention and management. It has been well documented that pain in newborns may result in direct and long-term consequences, altering both the behavior and neurologic development of the pain system. The alteration of the pain system during early infancy can lead to a decreased pain threshold in late infancy, a reduced pain perception after puberty and an increased pain perception as an adulthood (Kashaninia, Sajedi, Rahgozar, & Noghabi, 2008).
A study implemented skin-to-skin holding 10 minutes prior to, during and after an injection of Vitamin K on 50 newborns. The results of this study demonstrated dramatically reduced behavioral responses, such as facial expression, crying, changed breathing patterns, arm movement, leg movement and state of arousal, when compared to the 50 newborns in the control group who received no skin-to-skin holding prior to, during or after their injection (Kashaninia et al., 2008).
As a nurse, I have found the majority of mothers desire to be near their newborn infants when their infant is receiving their first Hepatitis B vaccination. In instances where the infant is breastfeeding or being held skin-to-skin, I have personally witnessed a decrease or complete absence of a pain response while administering the vaccination. I remember one mother specifically thanking me for allowing her to continue breastfeeding during administration of her son’s vaccine. The mother stated that with her previous children they were always taken out of her arms when receiving their vaccinations, and then returned to her crying and needing comfort from the pain.
Implementation of skin-to-skin has been well documented and demonstrated to be an effective, safe and an easily carried out non-pharmacological intervention for pain in newborns. I believe our families, who desire to comfort their newborns, minimize crying and prevent pain would appreciate the opportunity to hold their babies skin-to-skin during painful procedures, such as injections, when skin-to-skin proves to decrease pain and comfort their newborns.
Kashaninia, Z., Sajedi, F., Rahgozar, M., & Noghabi, F. A. (2008, March 20). The effect of kangaroo care on behavioral responses to pain of an intramuscular injection in neonates. Journal for Specialists in Pediatric Nursing, 13(4), 275-280. Retrieved from Academic Search Premier Database.
Jamie Detwiler, R.N., graduated from Indiana University South Bend with a bachelor’s in nursing. She works on the Mother-Baby Unit at Memorial Hospital because she wants to help make each family’s birthing experience positive and memorable. Jamie is currently pursuing a master’s in nursing and plans to become a Family Nurse Practitioner.