The Impact of Holding on Stress and Bonding in Mother-Infant Pairs During Therapeutic Hypothermia
The Impact of Holding on Stress and Bonding in Mother-Infant Pairs During Therapeutic Hypothermia
This research is being done to try to improve the experience of mothers and babies during
 therapeutic hypothermia. Currently, mothers are not able to hold their baby during
 hypothermia treatment. Mothers have reported that not being able to hold their baby during
 this time is stressful. Additionally, it is known that holding has many benefits for mothers'
 and babies' psychological and physical health.

 Therapeutic hypothermia is the standard of care. The experimental interventions of this study
 are to have mothers hold their babies during this treatment, collect saliva samples from
 mothers and babies, and test the saliva samples for the hormones cortisol and oxytocin. The
 investigators will test saliva of infants and their mothers before and after holding. The
 investigators hope to demonstrate decreased cortisol, a marker for stress, and increased
 oxytocin, a marker for bonding, in infants and mothers while they are held during therapeutic
 hypothermia.
The inability to hold an infant being treated with therapeutic hypothermia in the neonatal
 intensive care unit has been subjectively reported by ours and other research groups as a
 significant source of stress for parents. The investigators aim to assess the impact of
 holding on endocrinological markers of stress and bonding. Specifically, the investigators
 plan to collect salivary cortisol and oxytocin levels from infants undergoing therapeutic
 hypothermia and their mothers prior to and immediately after a 30-minute holding period.

 The investigators hypothesize that measurable increases in salivary oxytocin levels,
 coinciding with the reported qualitative increased levels of bonding, will be observed after
 the holding period. The investigators anticipate the reported stress reduction after holding
 to be quantified by measurable decreases in salivary cortisol levels. The investigators
 hypothesize these hormone changes will be present in both the mother and the infant when
 compared to samples taken without the holding intervention.
Inclusion Criteria:

 -  gestational age at birth of 35 weeks or greater

 -  absence of clinical or electrographic seizures during the first 24 hours of
 therapeutic hypothermia

 -  designation as "clinically stable" by the attending neonatologist on service

 -  respiratory status of: room air, nasal cannula, continuous positive airway pressure or
 intubated on conventional ventilator

 Exclusion Criteria:

 -  designation as "clinically unstable" by the a member of the medical team

 -  use of inhaled nitric oxide for persistent pulmonary hypertension of the newborn

 -  high frequency oscillator ventilation

 -  presence of electrographic seizures

 -  use of vasopressors or paralytic agents, presence of chest tubes, wound vacuums, or
 drains

 -  in utero opiate exposure