Background and aims Preterm infants should avoid stressful events, due to their immature brain and vascular structures. The purpose of this observational study was to investigate stress responses to nurse handling in the NICU.

Methods Fifteen male and fifteen female infants, gestational age 32,7 (±1, 48) weeks and birth weight 1880(± 409) grams, at postnatal day 5–7 were observed during nursing care and diaper change. Standard physiological measurements; heart rate (HR), respiratory rate (RR), and skin conductance response frequency (SCR/sec), and NIDCAP® behavioural stress cues; facial, visceral, motor, attentional, and self-consoling were recorded before and during care. Non-parametric Wilcoxon was used.

Results There were statistical differences for physiological and behavioural measures from before to during the care:

Conclusion SCR/sec, RR, HR and NIDCAP® stress behaviours all significantly increased during the care. Further analyses of the NIDCAP® subgroups identified motor and attentional cues, and ability to self-console as significant.