PS-195 Sucrose Versus Breastfeeding For Venipuncture In Term Infants. A Randomised, Prospective, Controlled Study With Analysis Of The Specific Cortical Response

Abstract

for ROP screening on the basis of birth weight and/ or gestational age. Only the first screening examination for each baby was considered. Premature babies, were randomised to one of three interventions before their screening examination: group 1 (n = 27) received 24% sucrose oral, group 2 (n = 27) received 24% sucrose with pacifier, group 3 (n = 27) received sterile water with pacifier. Pain responses were scored by using the PIPP. Results A total of 81 infants (42 males and 39 females) were enrolled in the study. The mean birth weight was 1280 ± 316 g, gestational age was 28.7 ± 2.1 weeks and corrected gestational age at examination was 34.2 ± 2.9 weeks. The mean PIPP scores in group 1, 2, and 3 were 16.7, 11.4 and 15.1, respectively. Sucrose with pacifier (group 2) had a significantly lower mean PIPP score than group 1 and 3 (p 0.014; 0.021, respectively). Conclusions Sucrose combined with NNS and NNS itself reduce pain scores during screening examinations for ROP. Background and aims Sucrose and breast milk during painful procedures are reported to decrease pain behavioural expression in neonates. Recent data showed a persistent cortical pain response while using the sucrose during a painful procedure. PS-195To compare the efficacy of sucrose versus breast milk for specific-pain brain activity relief during a painful procedure in neonates. Methods Randomised, prospective, controlled study. Each term newborn was randomly assigned to sucrose or breastfeeding group at day 3 during a systematic venipuncture. Change in the total haemoglobin concentration in the controlateral somatosensory cortex (Near Infra-red Spectroscoy, NIRS) was assessed 10 seconds before and after the venipuncture. Neonatal Facial Coding System (NFCS) was assessed 2 min before and at the time of the venipuncture. Groups were compared using Wilcoxon test for the variations in NIRS and Chi-square test for the NFCS scores. Results 113 newborns were included (sucrose: 56, breastfeeding: 57) with a mean (sd) of 39.3 weeks (0.9) for gestational age and 3370 g (478) for birth weight. 103 were analysed for the NIRS (sucrose: 55, breastfeeding: 48). Median (quartiles) of total haemoglobin concentration change was -8.5 mmol/L (-34.5; 12.5) for sucrose group and 12.3 mmol/L (-23.4; 39.3) for breastfeeding group with no statistical difference (p = 0.06). NFCS scores were significantly different with 46.8% with a painful score in the breastfeeding versus 26.8% in the sucrose (p = 0.03).Conclusions No difference were found between sucrose and breastfeeding on specific-pain brain activity during a venipuncture in term newborns. A discordance was revealed between NFCS scores and NIRS analysis. PS-196 WITHDRAWN PS-197 A RANDOMISED TRIAL OF ESTIMATING UMBILICAL CATHETER INSERTION DEPTH IN NEWBORNS USING BIRTH WEIGHT OR SURFACE MEASUREMENTS (ISRCTN17864069)E Kieran, E Laffan, C O'Donnell. Neonatology, The National Maternity Hospital, Dublin, Ireland 10.1136/archdischild-2014 Background Incorrect umbilical venous and arterial catheter (UAC and UVCs) tip pos...

Assessment and Management of Pain in Preterm Infants: A Practice Update

“…Direct breastfeeding has consistently been found to be more effective than comparator interventions, such as swaddling [ 71 , 73 ], maternal holding or SSC [ 74 , 75 , 76 , 77 , 78 ], topical anesthetics and cooling sprays [ 79 , 80 ], non-nutritive sucking [ 81 ], heel warming [ 82 ], music therapy [ 83 ], and placebo or no treatment [ 71 , 84 , 85 ]. Results are mixed when compared to sweet tasting solutions, however, direct breastfeeding has been found to be as or more effective [ 37 , 86 , 87 , 88 , 89 , 90 ]. Studies on the feeding of expressed breastmilk alone and without maternal contact report mixed results [ 72 ].…”

Emotional Processing in the First 2 Years of Life: A Review of Near‐Infrared Spectroscopy Studies

“…Somatosensory cortices activation has been noted in response to painful stimuli such as venipuncture or heel lance in infants . Although, some studies report no significant differences in cortical responses during painful stimuli in neonates by prior breastfeeding and sucrose administration . However, recent studies show that skin‐to‐skin contact with their mothers reduces contralateral somatosensory activation during venipuncture in premature infants.…”

“…[64][65][66] Although, some studies report no significant differences in cortical responses during painful stimuli in neonates by prior breastfeeding and sucrose administration. 67,68 However, recent studies show that skin-to-skin contact with their mothers reduces contralateral somatosensory activation during venipuncture in premature infants. This implies that skin-to-skin contact is an easy method by which parents can also get more involved in their infants' care and pain management.…”