Analgesia with breastfeeding in addition to skin-to-skin contact during heel prick

Abstract

This study suggests that BF in addition to SSC provides superior analgesia to other kinds of non-pharmacological analgesia in healthy term neonates during heel prick.

Clustered Pain Procedures in Skin-to-Skin Contact (SSC) Position for Full Term Newborns

“…Be sure that newborn is held securely and is up against the mother's skin. Reassure the mother that holding her newborn during the procedure is really one of the best ways (the best way is to keep the newborn skin-to-skin and breastfeed with the stick and squeezes [37]) she can help her newborn tolerate the procedure with less pain. If the infant is not crying, point this out to the mother and tell her "Your baby is not even crying.…”

Sedation in the Neonatal Intensive Care Unit: International Practice

“…It is believed that the effects of sucrose and nonnutritive sucking are mediated by both endogenous opioid and non-opioid systems. There is meta-analytical evidence in support of the use of oral administration of sucrose 24 %, glucose 30 %, or mother's milk in combination with a pacifier shortly before a painful procedure (e.g., blood sampling, nasogastric tube placement, immunization/vaccination) as an effective tool for procedural analgesia in neonates [51][52][53][54][55][56]. The observations on the use of sucrose during heel lancing hereby are much more common compared to other interventions or procedures.…”

“…This time interval is thought to coincide with the endogenous opioid release. When compared with local analgesia/EMLA or systemic acetaminophen (paracetamol) or morphine, glucose/ sucrose results in the most prominent decrease in pain scores [51][52][53][54][55][56]. More moderate positive results were obtained during immunization in infancy (2-6 months), resulting in the guidelines to use sweet solution with a pacifier (or other facility to maintain suctioning) only up to the age of 4, max 6 months [57].…”

“…In Table 15.2, we provide an illustrative overview of studies to illustrate the effectiveness of facilitated tucking in (pre)term neonates, either not combined with or compared to other complementary interventions, like oral sucrose, or nonnutritive sucking [56,[60][61][62][63][64][65][66][67][68][69]. Methodologically, the majority of these studies were not blinded and applied a crossover type of design, yet order effects are only rarely reported.…”

“…Methodologically, the majority of these studies were not blinded and applied a crossover type of design, yet order effects are only rarely reported. However, the available evidence points to a modest reduction in pain scores and physiological fluctuations and a faster return to baseline [56,[60][61][62][63][64][65][66][67][68][69]. To test the comparative effectiveness of different non-pharmacological pain-relieving interventions, either applied alone or in combination to document potential synergism, effectiveness of oral sucrose, facilitated tucking, or both, a prospective study in 71 preterm (24-32 gestational age) neonates was performed in three NICUs in Switzerland [65].…”