Analgesic effect of breast feeding in term neonates: randomised controlled trial |
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| Authors: | Ricardo Carbajal Soocramanien Veerapen Sophie Couderc Myriam Jugie Yves Ville |
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| Institution: | aDepartment of Paediatrics, Poissy-Saint Germain Hospital, 78300 Poissy, France, bDepartment of Gynaecology and Obstetrics, Poissy-Saint Germain Hospital, cMaternity Ward, Poissy-Saint Germain Hospital |
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| Abstract: | ObjectivesTo 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.DesignRandomised controlled trial.Participants180 term newborn infants undergoing venepuncture; 45 in each group.InterventionsDuring 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.ResultsMedian 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).ConclusionsBreast feeding effectively reduces response to pain during minor invasive procedure in term neonates. What is already known on this topicCurrent pharmacological treatments are not appropriate for pain relief during minor procedures like venepuncture or heel prick in newborn infantsOral sweet solutions, non-nutritive sucking, and skin to skin contact reduce procedural pain in newborn infantsWhat this study addsBreast feeding during a painful procedure effectively reduces the response to pain in newborn infantsThe analgesic properties of breast feeding are at least as potent as the combination of sweet solutions and a pacifier |
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