Understanding maternal perspectives of skin-to-skin contact for the management of acute pain in very and extremely preterm infants.

Skin-to-skin care (SSC) and skin-to-skin contact for procedural pain (SSCP) are recognized for their physiological and emotional benefits in the neonatal intensive care unit (NICU), including pain reduction in preterm infants. However, little is known about how birthing parents of very and extremely preterm infants (<32 weeks gestational age), a significantly more challenging preterm infant population to enact SSCP, perceive this intervention. This study aimed to explore birthing parents' experiences and perceptions related to the use of SSC and SSCP in the NICU with their very and extremely preterm infants. In partnership with a national preterm parent organization, virtual interviews were conducted with 38 mothers of very or extremely preterm infants from across Canada, who had been admitted to the NICU within the past 5 years. Data were synthesized into 8 primary themes relating first to SSC broadly and then SSCP. In addition, mothers' opinions about a priori concepts and potential interventions (generated from pilot data) were also vetted. Important actionable facilitators and barriers related to fears and interventions to support SSCP with parents of very and extremely preterm infants were discerned. Although most found their experience rewarding, barriers such as limited instruction, inconsistent staff support, procedural challenges, and emotional strain often hindered the use of SSCP. Enhancing staff training, standardizing protocols, offering mental health support, and adopting flexible, family-centered policies appear key to improving SSCP engagement with the youngest preterm infants.