Background
Parent holding and skin-to-skin kangaroo care are associated with benefits for sick and preterm infants infant and their mothers.  Traditional physiological monitoring requires multiple wired connections which may impede infant transfer and parental holding.  The effect of parental holding on autonomic function in the infant is unknown.
This study aimed to investigate the feasibility of a wireless heart rate monitor to assess autonomic function during parent holding in newborn infants.

Methods
Prospective observational study.  ECGs were recorded using a two-lead wireless sensor transmitting to a networked gateway monitor (Patient Status Engine, Isansys Lifecare, UK), Figure 1.  Autonomic function was assessed by calculation of heartrate variability (HRV) parameters using specialised software incorporating artefact correction (Kubios HRV).  HRV parameters were compared using repeated measures analysis between thirty-minute periods immediately pre-, during, and post parent holding.

Results
140 parent holding episodes were analysed in 10 infants.  Wireless monitoring was tolerated in all cases and acceptable to parents and clinical staff.  Sensor detachment during holding preventing data analysis in 20 cases.  

There was a significant increase in R-R interval (reduced heartrate) during holding episodes (P<0.001).  There were no significant differences in HRV parameters between pre-holding, holding and post-holding periods, Table 1.   

Conclusions
•	Wireless ECG monitoring is feasible in the newborn infant and may facilitate parental holding.
•	Parent holding is associated with autonomic stability in the sick newborn infant

7th Congress of the European Academy of Paediatric Societies