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Parental holding during therapeutic hypothermia: Benefit or burden?

Pediatric Research volume 98, pages 1184–1185 (2025)Cite this article

The Original Article was published on 16 January 2025

In this issue of Pediatric research, Gancarski et al. present an observational, prospective cohort study investigating the physiological and behavioral stability of infants undergoing therapeutic hypothermia (TH) for hypoxic-ischemic encephalopathy (HIE) during parental holding.1 They included 30 near-term infants who were held once by their parents during TH for a mean duration of 83 (SD 26) min (n = 6 on day 1, n = 16 on day 2 and n = 8 on day 3). On average, 2.6 nurses were required for transferring the baby. Physiological data such as body temperature and vital signs were recorded before, during and after the holding session, alongside several measures (COMFORT-B, pain score and arousal state) to assess the infant’s comfort. Additionally, both parents and nurses completed questionnaires evaluating satisfaction, apprehension, reassurance, discomfort and workload.

In two infants, a temperature above 34 °C was recorded, though only one experienced this during the holding session. The other infant had an elevated temperature prior to holding. No significant changes were observed in vital signs, and no early termination of parental holding occurred due to persistent bradycardia, more than 10% FiO2 increase, or accidental dislodgement of tubes or catheters. Furthermore, no significant changes were noted in arousal state, pain or comfort scores. Interestingly, although not statistically significant, fewer infants exhibited behavioral signs of discomfort at the end of the holding session compared to before or after, suggesting a potential benefit of parental holding on the baby’s comfort. Parents reported high satisfaction and minimal discomfort, while nurses also expressed a high level of satisfaction, though they reported a slight increase in workload and low apprehension regarding clinical destabilization. The authors concluded that parental holding during TH for HIE is safe, well-received by parents and nurses, and aligns with family-centered care principles.

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Author notes

  1. These authors contributed equally: Lauren C. Weeke, Marije Hogeveen.

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  1. Department of Neonatology, Radboudumc, Nijmegen, The Netherlands

    Lauren C. Weeke & Marije Hogeveen

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  1. Lauren C. Weeke
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  2. Marije Hogeveen
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Correspondence to Marije Hogeveen.

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Weeke, L.C., Hogeveen, M. Parental holding during therapeutic hypothermia: Benefit or burden?. Pediatr Res 98, 1184–1185 (2025). https://doi.org/10.1038/s41390-025-04176-w

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