Skin-to-skin contact significantly impacts maternal anxiety, mother-infant bonding, and autonomic function in infants with congenital heart disease and their mothers

Mothers of infants in the cardiac intensive care unit (CICU) experience stress, anxiety, and impaired bonding. Infants with congenital heart disease (CHD) experience dysregulation of autonomic function. Skin-to-skin contact (SSC) alleviates stress in both mothers and infants, but its use remains understudied in the CHD population. In this single-center, prospective pilot study, we evaluated the impact of low-dose postoperative SSC (three sessions within a 10-day period) on maternal mood, measured by the State Trait Anxiety Inventory (STAI-6) and the Depression Anxiety Stress Scale (DASS-21), mother-infant bonding, and autonomic function, measured by heart rate variability (HRV), in infants with CHD and their mothers. Twenty-one mother-infant dyads participated in 51 SSC sessions. STAI-6 and bonding scores significantly improved after just one session of SSC (p < 0.001, p = 0.004, respectively). All metrics of HRV-low frequency (LF) (p < 0.001), high frequency (HF) (p < 0.001), the standard deviation of normal-to-normal intervals (SDNN) (p < 0.001), the root mean square of successive differences RMSSD (p = 0.032), and the SDNN/ RMSSD ratio (p < 0.001)-significantly decreased during SSC in mothers. LF (p = 0.036), HF (p = 0.034), and the SDNN/ RMSSD ratio (p = 0.008) significantly decreased during SSC in infants. Our data suggest that low-dose SSC significantly impacts autonomic function of both mothers and CHD infants and improves maternal anxiety and perceptions of bonding, although more studies are needed to understand the relationship between HRV and stress in this population.