Analgesic effect of breast feeding in term neonates: randomised controlled trial

Abstract

Objectives To investigate whether breast feeding is effective for pain relief during venepuncture in term neonates and compare any effect with that of oral glucose combined with a pacifier. Design Randomised controlled trial. Participants 180 term newborn infants undergoing venepuncture; 45 in each group. Interventions During venepuncture infants were either breast fed (group 1), held in their mother's arms without breast feeding (group 2), given 1 ml of sterile water as placebo (group 3), or given 1 ml of 30% glucose followed by pacifier (group 4). Video recordings of the procedure were assessed by two observers blinded to the purpose of the study. Main outcome measures Pain related behaviours evaluated with two acute pain rating scales: the Douleur Aiguë Nouveau-né scale (range 0 to 10) and the premature infant pain profile scale (range 0 to 18). Results Median pain scores (interquartile range) for breast feeding, held in mother's arms, placebo, and 30% glucose plus pacifier groups were 1 (0-3), 10 (8.5-10), 10 (7.5-10), and 3 (0-5) with the Douleur Aiguë Nouveau-né scale and 4.5 (2.25-8), 13 (10.5-15), 12 (9-13), and 4 (1-6) with the premature infant pain profile scale. Analysis of variance showed significantly different median pain scores (P < 0.0001) among the groups. There were significant reductions in both scores for the breast feeding and glucose plus pacifier groups compared with the other two groups (P < 0.0001, two tailed Mann-Whitney U tests between groups). The difference in Douleur Aiguë Nouveau-né scores between breast feeding and glucose plus pacifier groups was not significant (P=0.16). Conclusions Breast feeding effectively reduces response to pain during minor invasive procedure in term neonates.

Analgesic Effects of Sweet-Tasting Solutions for Infants: Current State of Equipoise

“…[52][53][54][55][56][57] Kangaroo care 58,59 and breastfeeding [60][61][62][63][64] were more or equally effective, compared with sucrose alone, in most studies, with few exceptions. [65][66][67] Sucrose or glucose was equal to or more effective than eutectic mixture of topical anesthetics during heel lances, 68 finger pricks, 69 …”

Prevention and Management of Pain in the Neonate: An Update

“…These include use of oral sucrose/glucose, [62][63][64][65][66][67][68][69][70][71][72][73][74][75][76] breastfeeding, 77 nonnutritive sucking, 49,78 "kangaroo care" (skin-to-skin contact), 55,58 facilitated tuck (holding the arms and legs in a flexed position), 79 swaddling, 80 and developmental care, which includes limiting environmental stimuli, lateral positioning, the use of supportive bedding, and attention to behavioral clues. 61 These measures have been shown to be useful in preterm and term neonates in reducing pain from a heel stick, 68,[70][71][72][73]79,80 venipuncture, 62,64,65,67,74,77,81 and subcutaneous injections 81 and are generally more effective when used in combination than when used alone. 63,65,68,69,80,82 Concentrated oral sucrose has been widely studied.…”

What influence does experience play in heel prick blood sampling?

“…A number of studies have advocated the analgesic effect of breast feeding during painful procedures (Carbajal et al, 2003;Gray et al, 2002). Carbajal et al (2003) studied 180 babies undergoing venepuncture and found that breastfeeding during the procedure significantly reduced the infant's apparent pain.…”