Breast milk vs. non-nutritive sucking to reduce pain from minor invasive procedures in neonates
Keywords:
breast milk, non-nutritive sucking, pain, invasive minor procedure, neonates
Abstract
Background Neonates undergo many uncomfortable, invasiveminor 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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15. Serpa AB, Guinsburg R, Balda Rde C, dos Santos AM, Are co
KC, Peres CA. Multidimension al pain assessment of preterm
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org/pdf/pdf]USABIL ~572.pdf
C, Lott JW, editors. Comprehensive neonatal care an
interdisciplinary approach. 4th ed. St Louis: Saunders Elsevier;
2007. p. 360-71.
2. Anand KJS, Aranda JV, Berde CB, Buckman S, Capparelli
EV, Carlo W, et al. Summary proceedings from the neonatal
pain-control group. Pediatrics. 2005;117:9-22.
3. Carbajal R, Chauvet X, Couders S, Martin MO. Randomised
trial of analgesic effects of sucrose, glucose, and pacifiers in
term neonates. BMJ. 1999;319:1393-7
4. Hummel P, Puchalski M, Creech SD, Weiss MG. Clinical
reliability and validity ofN-PASS: neonatal pain, agitation,
and sedation scale with prolonged pain. J Perinatol.
2008;28:55-60.
5. Khurana S, Hall RW, Anand KJS. Treatment of pain
and stress in the neonate: when and how. Neoreviews.
2005;6:76-87.
6. Ballantyne M, Stevens B, McAllister M, Dionne K, Jack A.
Validation of the premature infant pain profile in the clinical
setting. Clin J Pain. 1999;15:297-303 .
7. Guinsburg R, Peres CA, Almeida MFB, Balda R, Berenguel
RC, Toneletto J, et al. Differences in pain expression between
male and female newborn infant. Pain. 2000;85:127-33.
8. Efe E, Ozer ZC. The use of breast feeding for pain relief
during neonatal immunization injections. Appl Nurs Res.
2007;20: 10-6.
208 • Paediatr lndones, Vol. 53, No. 4, July 2013
9. Upadhyay A, Aggarwal R, Narayan S, Joshi M, Paul VK,
Deorari AK. Analgesic effect of expressed breast milk in
procedural pain in term neonates: a randomized, placebocontrolled,
double-blind trial. Acta Paediatr. 2004;93:518-
22.
10. Blass EM, Miller LW Effect of colostrum in newborn humans:
dissociation between analgesic and cardiac effects. J Dev
Behav Pediatr. 2001 ;22:385-90.
11. Phillips RM, Chantry CJ, Gallagher MP. Analgesic effects of
breast-feeding or pacifier use with maternal holding in term
infants. Ambul Pediatr. 2005 ;5:359-64.
12. Uyan ZS, Ozek E, Bilgen H, Cebeci D, Akman I. Effect
of foremilk and hindmilk on simple procedural pain in
newborns. Pediatr Int. 2005;47:252-7.
13. Gradin M, Finnstrom 0, Schollin J. Feeding and oral glucoseaddictive
effects on pain reduction in newborns. Early Hum
Dev. 2004;77:57-65.
14. Corbo MG, Mansi G, Stagni A, Romano A, Heuvel JV,
Capasso L, et al. Nonnutritive sucking during heelstick
procedure decreases behavioral distress in the newborn
infant. Biol Neonate. 2000;77:162-7.
15. Serpa AB, Guinsburg R, Balda Rde C, dos Santos AM, Are co
KC, Peres CA. Multidimension al pain assessment of preterm
newborns at the 1 ", yd, and 7'h days of life. Sao Paulo Med
J. 2007; 125:29-33.
16. Derebent E, Yigit R. Non-pharmacological pain man agement
in newborn. 2008;22:1 13-8. Available from: http://tip.fusabil.
org/pdf/pdf]USABIL ~572.pdf
Published
2013-08-31
How to Cite
1.
Marisya S, Tjipta G, Supriatmo S, Azlin E. Breast milk vs. non-nutritive sucking to reduce pain from minor invasive procedures in neonates. PI [Internet]. 31Aug.2013 [cited 22Nov.2024];53(4):204-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/282
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Received 2016-08-21
Accepted 2016-08-21
Published 2013-08-31
Accepted 2016-08-21
Published 2013-08-31
