Pain Relief in Babies

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These studies look at the protective effect of breastfeeding on newborn pain.

The impact of breastmilk smell on newborn pain

This study evaluated the effect of the smells of amniotic fluid, breast milk, and lavender on the pain of newborns during heel lance. It was found that the smells of lavender and breast milk helped prevent heart rates from rising and oxygen saturation rates from falling, and reduced the Neonatal Infant Pain Scale score during the invasive procedures in newborns more than amniotic fluid or the control group.

Akcan, E et al (2016), Comparative Effect of the Smells of Amniotic Fluid, Breast Milk, and Lavender on Newborns’ Pain During Heel Lance, Breastfeeding Medicine, doi:10.1089/bfm.2015.0174

Breastfeeding provides optimum pain control during heel prick testing for neonates

A prospective study was conducted of 180 term newborn infants who were undergoing routine heel prick testing for neonatal screening of phenylketonuria and hypothyroidism. The babies were assigned to six groups: control (no pain relief); breastfeeding; non-nutritive sucking; holding by mother; oral glucose solution; or oral formula feeding. The babies pain experience was analysed related to a validated scoring system – Neonatal Facial Coding System, duration of crying and autonomic variables obtained from analysis of heart rate variability before, during, and after heel prick test.

The researchers found that infants with no pain control showed the highest pain scores compared with newborns to whom pain control was provided. Infants who breastfed showed the lowest increase in heart rate when compared with no pain relief (21 beats per minute vs 36), the lowest neonatal facial score (2.3 vs 7.1), lowest cry duration (5 vs 49), and lowest decrease in parasympathetic tone (–2 vs 1.2) and also when compared with the alternative interventions studied. Bottle feeding with infant formula also showed better effects than the other interventions, however was not as effective as breastfeeding. The authors conclude that any method of pain control is better than none. Feeding and in particularly breastfeeding during heel prick testing were found to be the most effective methods of pain relief.

Weissman A, Aranovitch M, Blazer S et al (2009) Heel-Lancing in Newborns: Behavioral and Spectral Analysis Assessment of Pain Control Methods. PEDIATRICS (doi:10.1542/peds.2009-0598)

Impact of the odour of mothers’ own breastmilk on neonatal pain

A study in Japan was carried out to investigate whether the smell of a mother’s own breastmilk would impact upon neonatal pain responses when compared with breastmilk from another mother or infant formula. Healthy term infants were observed undergoing routine heelprick testing at five days of age.

The researchers noted that after the heelprick, the responses of those with their own mother’s breastmilk group were lower than those of other groups. In addition, in a group of the babies, salivary cortisol concentration was measured to assess pain using a biochemical index. The authors suggest that pain is relieved in human newborns when they are exposed to odours from their mother’s milk.

Nishitani S, Miyamura T, Tagawa M et al (2009)The calming effect of a maternal breast milk odor on the human newborn infant. Neuroscience Research: 63; 66-71

Breastfeeding reduces pain scores in term infants undergoing neonatal screening

A study conducted in Italy with the aim of comparing breastfeeding with orally administered sucrose solution in reducing pain response during blood sampling using the heel prick technique. The researchers conclude that the study suggests that breastfeeding provides superior analgesia for heel pricks compared with oral sucrose in term neonates.

Codpietro L, Ceccarelli M, Ponzone A. (2008) Breastfeeding or oral sucrose solution in term neonates receiving heel lance: a randomized, controlled trial. Pediatrics; 122: e716-21.

Breastfeeding and breastmilk reduce pain in neonates

A Cochrane Review of 11 studies has found that breastfeeding and breastmilk are effective interventions to reduce pain in neonates. The authors recommend that when available, breastfeeding or breastmilk should be provided as analgesia for neonates undergoing single painful procedures.

Shah PS, Aliwalas LL, Shah V. Breastfeeding or breast milk for procedural pain in neonates. The Cochrane Database of Systematic Reviews 2006; Issue 3