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Updated: Mar 21, 2026
A Preterm Rat Model for Pain Studies
Published on: February 9, 2024
Neonatal pain and reduced maternal care: Early-life stressors interacting to impact brain and behavioral development
Sean M Mooney-Leber1, Susanne Brummelte1
1Department of Psychology, Wayne State University, Detroit, MI, United States.
Insights
Kangaroo care may improve preterm infant outcomes by reducing stress responses. This non-pharmacological approach, involving skin-to-skin contact, appears to mitigate negative effects of neonatal intensive care unit (NICU) stressors on the hypothalamic-pituitary-adrenal (HPA) axis.
Area of Science:
- Neonatal intensive care
- Neuroscience
- Developmental psychology
Background:
- Preterm infants in NICUs face stressors like painful procedures and limited maternal contact.
- These stressors activate the hypothalamic-pituitary-adrenal (HPA) axis, impacting brain development and leading to adverse outcomes.
- The biological mechanisms underlying these effects and the benefits of Kangaroo care are not fully understood.
Purpose of the Study:
- To review the literature on neonatal pain and reduced maternal care.
- To investigate the role of the HPA axis in neonatal stress and biobehavioral outcomes.
- To explore the potential mechanisms of Kangaroo care in mitigating these adverse effects.
Main Methods:
- Literature review of human and rodent studies.
- Focus on research examining the HPA axis response to neonatal stressors.
- Analysis of biobehavioral outcomes associated with neonatal care practices.
Main Results:
- Neonatal pain and reduced maternal contact activate the HPA axis, linked to adverse biobehavioral outcomes.
- Kangaroo care shows promise in negating negative outcomes associated with neonatal pain and reduced maternal care.
- The precise biological pathways through which Kangaroo care exerts its benefits require further elucidation.
Conclusions:
- Kangaroo care may counteract the detrimental effects of NICU stressors by modulating the HPA axis.
- Increased skin-to-skin contact offers a non-pharmacological approach to improve preterm infant well-being.
- Further research is needed to fully understand the neurobiological underpinnings of Kangaroo care's efficacy.
Abstract:
Advances in neonatal intensive care units (NICUs) have drastically increased the survival chances of preterm infants. However, preterm infants are still exposed to a wide range of stressors during their stay in the NICU, which include painful procedures and reduced maternal contact. The activation of the hypothalamic-pituitary-adrenal (HPA) axis, in response to these stressors during this critical period of brain development, has been associated with many acute and long-term adverse biobehavioral outcomes. Recent research has shown that Kangaroo care, a non-pharmacological analgesic based on increased skin-to-skin contact between the neonate and the mother, negates the adverse outcomes associated with neonatal pain and reduced maternal care, however the biological mechanism remains widely unknown. This review summarizes findings from both human and rodent literature investigating neonatal pain and reduced maternal care independently, primarily focusing on the role of the HPA axis and biobehavioral outcomes. The physiological and positive outcomes of Kangaroo care will also be discussed in terms of how dampening of the HPA axis response to neonatal pain and increased maternal care may account for positive outcomes associated with Kangaroo care.
