Effects of breastfeeding and heel warming on pain levels during heel stick in neonates

Abstract

Aim To determine the effects of two different methods, breastfeeding and heel warming, during heel stick procedures on pain levels in healthy term neonates. Methods This study was a prospective, randomized controlled trial. The sample of the study consisted of 150 healthy newborns who matched the case selection criteria and were brought to the nursery for the heel stick procedure. Fifty neonates were randomly assigned to each group: breastfeeding (n = 50), heel warming (n = 50), and control (n = 50), using computer‐based randomization. The study data were obtained using an Information Form and the Neonatal Infant Pain Scale (NIPS). Results The pre‐procedural pain scores of the breastfeeding group (mean 4.44 SD 1.21 seconds) were lower than in the heel warming (mean 6.10 SD 1.07 seconds) and the control group (mean 6.42 SD 0.91 seconds) (P < 0.01). Both the total crying time and the first calming time of the breastfeeding group were shorter than the heel warming and control group. The first calming time of the heel warming group was shorter than in the control group. Conclusions Both breastfeeding and heel warming are effective in reducing the calming time during heel stick procedures. However, breastfeeding is more effective than heel warming in reducing pain during heel stick and should be preferred as the first choice.

Development of locally relevant clinical guidelines for procedure-related neonatal analgesic practice in Kenya: a systematic review and meta-analysis

“…12 studies (n=991) compared breastfeeding with placebo or no intervention. [22][23][24][25][26][27][28][29][30][31][32][33] Narrative synthesis further supported this finding with all 12 studies finding a superiority of breastfeeding compared with placebo or no intervention (appendix p 8). Therefore, the NPGG had a high level of certainty in the superiority of breastfeeding over placebo or no intervention when initiated at least 2 min before the painful procedure (appendix p 7).…”

“…PICO question comparisons that were prioritised by the NPGG in their discussions were those involving breastfeeding, oral sugar, expressed breastmilk, skin-to-skin care, and non-nutritive sucking. 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 ...…”

“…12 studies (n=991) compared breastfeeding with placebo or no intervention. 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 Meta-analysis showed evidence for a reduction in PIPP score (SMD −1·40 [95% CI −1·96 to −0·84]; n=327) and NIPS score (−2·20 [–2·91 to −1·48]; n=225; figure 2A ; appendix p 14 ), although not for heart rate (−1·49 [–3·44 to 0·46]; n=210) or SpO2 (0·59 [–1·26 to 2·43]; n=150; appendix pp 12, 13 ). Narrative synthesis further supported this finding with all 12 studies finding a superiority of breastfeeding compared with placebo or no intervention ( appendix p 8 ).…”

Breastmilk as a Multisensory Intervention for Relieving Pain during Newborn Screening Procedures: A Randomized Control Trial

“…Furthermore, some other studies report that neonates breastfed by their mothers while undergoing intrusive procedures could relieve pain caused by heel stick procedures [ 37 , 38 ]. Breast feeding provided by the mother is encouraged by the BFHI policies and has been validated to be effective on pain relief during short intrusive procedures [ 37 , 38 ].…”

“…Furthermore, some other studies report that neonates breastfed by their mothers while undergoing intrusive procedures could relieve pain caused by heel stick procedures [ 37 , 38 ]. Breast feeding provided by the mother is encouraged by the BFHI policies and has been validated to be effective on pain relief during short intrusive procedures [ 37 , 38 ]. However, our study did not use the intervention of breast feeding provided by the mother to relieve heel stick pain because most mothers were reluctant to see their infants undergoing painful procedures.…”