“…Several studies report that stress behaviours manifest during exposure to stressors include finger splaying, brow raising, yawn, tremor and extension that are followed by a decline in oxygen saturation and an increase in high heart rate (Grunau et al, 2000; Harrison et al, 2004), a flexed body, extended legs and frown on painful stimulations (Holsti et al, 2005). Observation of sleep–wake states provides additional information regarding central nervous system maturation and organization (Scher et al, 2003) as well as developmental patterns (Holditch-Davis et al, 2003; Giganti et al, 2001; Weisman et al, 2011). It is logical to assume that while minimizing stress, and in turn, the abnormal responses to stressful stimuli will reduce the energy expenditure and improve neurological integration, growth and development of preterm infants.…”