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The Academy of Breastfeeding Medicine Protocol Committee
BREASTFEEDING MEDICINE Volume 5, Number 6, 2010

Background

Newborns and young infants routinely experience pain associated with commonly used invasive procedures such as blood sampling and intramuscular injections (e.g., vaccinations, vitamin K) and, in some countries, circumcision (the removal of some or all of the foreskin [prepuce] from the penis). Reduction of pain is both a professional imperative and an ethical expectation because untreated pain has detrimental consequences such as greater pain sensitivity in later childhood and may lead to permanent neuroanatomical and behavioral abnormalities as demonstrated in animal models. Moreover, pain is a source of concern and distress for new parents and may disturb mother–infant bonding.

Leite AM, Linhares MB, Lander J, Castral TC, dos Santos CB, Silvan Scochi CG.
Clin J Pain. 2009 Nov-Dec;25(9):827-32.

Abstract

Breastfeeding may be useful for relieving procedural pain experienced by neonates. Researchers have compared breastfeeding against other pain relieving approaches in several studies, presenting marked methodologic heterogeneity.

OBJECTIVE: To investigate the effectiveness of breastfeeding in reducing pain in newborns undergoing blood collection for newborn screening. METHOD: The sample of this randomized clinical trial study consisted of 60 full-term newborns: 31 in the experimental group and 29 in the control group. The experimental group was breastfed 5 minutes before, during, and for 5 minutes after the blood collection procedure. Neonates in the control group were held in mothers' arms but not fed or given a soother. The duration of breastfeeding was prolonged in comparison to previous studies.

C C Johnston, F Filion, M Campbell-Yeo, C Goulet, L Bell, K McNaughton and J Byron

Journal of Perinatology (2009) 29, 51–56

Objective: To test if enhancing maternal skin-to-skin contact, or kangaroo mother care (KMC) by adding rocking, singing and sucking is more efficacious than simple KMC for procedural pain in preterm neonates.

Nishitani S, Miyamura T, Tagawa M, Sumi M, Takase R, Doi H, Moriuchi H, Shinohara K.

Neurosci Res. 2008 Nov 1. [Epub ahead of print]

Abstract

We examined the effects of the odors from mother's milk, other mother's milk and formula milk on pain responses in newborns undergoing routine heelsticks.

Luigi Codipietro, Manuela Ceccarelli, and Alberto Ponzone

PEDIATRICS Vol. 122 No. 3 September 2008, pp. e716-e721

Abstract

OBJECTIVE. The purpose of this work was to compare the efficacy of breastfeeding versus orally administered sucrose solution in reducing pain response during blood sampling through heel lance.

A csecsemőtáplálás módjának a csecsemő és az anya egészségére gyakorlt hatásával kapcsolatos kutatási eredmények jól áttekinthető összefoglalása.

Letölthető a La leche League International oldaláról.

Prakesh S. Shah, Lucia Aliwalas, Vibhuti Shah. Breastfeeding Medicine. 2007, 2(2): 74-82.

Abstract

Objectives: To (1) compare breastfeeding with control (placebo, no treatment, sucrose, glucose, pacifiers, or positioning) and (2) compare breastmilk with control for procedural pain in neonates.

Informed - A fájdalom által kiváltott élettani változások befolyásolják a morbiditás alakulását újszülötteknél. Klinikai tanulmányok csökkenést mutattak ki az élettani paraméterekben és a fájdalom objektíve mérhető értékeiben, ha előzetesen fájdalomcsillapítót adtak olyan újszülötteknek, akiknél valamilyen fájdalom vagy stresszes állapot állott fenn. Erre a célra nem-gyógyszeres (ringatás, pólyázás, szoptatás), valamint gyógyszeres (acetaminofen, szaharóz, opioidok) eljárásokat alkalmaztak.

PS Shah, LL Aliwalas, V Shah

Cochrane Database of Systematic Reviews 2006 Issue 3

Abstract

Background
Physiological changes brought about by pain may contribute to the development of morbidity in neonates. Clinical studies have shown reduction in the changes in physiological parameters and pain score measurements following pre-emptive analgesic administration in situations where the neonate is experiencing pain or stress. Nonpharmacological measures (such as holding, swaddling, breastfeeding) and pharmacological measures (such as acetaminophen, sucrose and opioids) have been used for this purpose.

Objectives
The primary objective of this review was to evaluate the effectiveness of breastfeeding or supplemental breast milk in reducing procedural pain in neonates. The secondary objective was to conduct subgroup analyses based on the type of control intervention, type of painful procedure, gestational age and the amount of supplemental breast milk given.

Newborn infants routinely undergo painful invasive procedures, even after uncomplicated birth. Evidence shows that neonates do feel pain and may even have increased sensitivity to pain and to its long term effects compared with older infants. Treating procedural pain has become a crucial part of neonatal care. In healthy infants, the most common painful procedures are heel lance and venepuncture. Pharmacological treatments are rarely used during these procedures because of con­cerns about their effectiveness (topical local anaesthetic
or paracetamol for heel pricks) and potential adverse effects (central analgesics). Therefore, non­ pharmacological interventions are valuable alternatives.

Larry Gray, Lisa W. Miller, Barbara L. Philipp, Elliott M. Blass

PEDIATRICS Vol. 109 No. 4 April 2002, pp. 590-593

Abstract

Context. This study identifies a behavioral and nonpharmacologic means of preventing newborn pain.

Objective. To determine whether breastfeeding is analgesic in newborn infants undergoing heel lance—a routine, painful, hospital procedure.