Semi-seated holding position to reduce stress responses in spontaneously crying newborns in the neonatal intensive care unit: A randomised experimental study

Abstract

Background and aim: Crying in newborns in the neonatal intensive care unit (NICU) is often a sign of stress caused by various stressors. Early-life stress can disrupt brain development, leading to lifelong neurodevelopmental disorders. Effective methods to reduce stress responses in newborns are therefore critical. This study aimed to investigate and compare the effects of a semi-seated holding position (SSHP) and facilitated tucking in a side-lying position (FTP) on hormonal and physiological stress responses in spontaneously crying newborns hospitalized in the NICU Methods: An open-label, randomized experimental study was conducted between July and November 2023 at the NICU of X Hospital, X City. Newborns were randomized into two groups: SSHP (45° semi-seated holding) or FTP (facilitated tucking in a side-lying position). Salivary cortisol and oxytocin levels were measured as primary outcomes, while physiological responses (heart rate, respiratory rate, body temperature, and O2 saturation) were secondary outcomes. Measurements were taken before and after positioning Results: A total of 45 newborns completed the study. Cortisol levels decreased in the SSHP group and increased in the FTP group; however, the changes were not statistically significant. Oxytocin levels significantly decreased in the SSHP group but not in the FTP group. Heart and respiratory rates decreased significantly in both groups following positioning, with no significant differences between groups. Conclusions: The SSHP is as effective as FTP in reducing stress responses among crying neonates in the NICU. This simple, equipment-free positioning method offers a practical alternative for promptly soothing infants.

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