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minor procedures during their first hospital stay. Nonpharmacological
interventions may provide valuable alternatives
for pain relief in neonates during minor procedures.
Objective To compare the analgesic effect of orally administered
breast milk vs. non-nutritive sucking (NNS) in neonates who
underwent minor invasive procedures.
Methods A randomized, open trial was performed at the Haji Adam
Malik Hospital from September to December 2009. Subjects were 96
healthy, term infants who received injections of either intramuscular
hepatitis B immunization or vitamin K. Subjects were randomly
allocated into two groups, those were the breast milk group (n = 48)
and the NNS group (n= 48). Breast milk and NNS were given two
minutes before the injection. The events were recorded by video
recorder. Transcutaneous heart rate, oxygen saturation and crying
times were recorded. Two observers used the premature infant pain
profile (PIPP) scale to evaluate all subjects.
Result.s In the breast milk group, there was significant reduction in
meanPIPPscore (P= 0.001) and mean crying time (P= 0.03) compared
to the NNS group. There were no significant differences in mean PIPP
score and crying times between males and females (P= 0.4 and P=0.5,
respectively). However, there was a significantly lower mean PIPP score
for vitamin K injection than for hepatitis B immunization (P=0.002),
although mean crying times were not significantly different (P= 0.06).
We observed significantly less Oz desaturation at 150 seconds postinjection
in the breast milk group compared to that of the NNS group.
However, there was no significant difference in heart rate between the
two groups throughout the observation period.
Conclusion Breast milk administered before an invasive minor
procedure effectively reduces pain in neonates. Breast milk
administered to neonates prior to injection has reduced mean PIPP
scores, crying times, and Oz desaturation, compared to neonates
who received NNS in the form of pacifiers.
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