Evaluation of Pain Response of Expressed Breast Milk Versus Placebo During Intravenous Cannulation in Neonates
Authors
##plugins.themes.bootstrap3.article.sidebar##
##plugins.themes.bootstrap3.article.main##
Abstract
Objective: To evaluate pain response of expressed breast milk (EBM) versus placebo during intravenous (IV) cannulation in neonates admitted in NICU by neonatal infant pain scale (NIPS). Study design: Non-blinded randomized control study. Place and duration: Neonatal Intensive Care Unit of Dr. D.Y. Patil Medical College, Hospital & Research Institute, Kolhapur from 5th December 2022 to 5th May 2024. Materials and Methods: This study included 257 neonates (128 in EBM and 129 in placebo group) with more than 32weeks of gestational age and who needed IV canulation. The neonates were exposed to EBM and sterile water of 2 ml by sterile syringe starting two minutes prior and during the procedure in EBM and placebo groups respectively. A senior resident put 26G needle IV canula for all neonates in first attempt. NIPS was utilized for the evaluation of the pain and the gross pain score was interpreted as: 0-2 (no pain), 3-4 (moderate pain), greater than 4 (severe pain). This score was calculated during and till 30 seconds after the first prick. Results: The mean NIPS score in EBM group was significantly less compared to placebo group (2.56 vs 3.81, P<0.0001). The individual variables of NIPS observed significantly lower scores in EBM group as compared to placebo group. The placebo group experienced higher levels of pain as compared to EBM group. Conclusion: EBM as a non-pharmacological intervention demonstrated superior efficacy in reducing pain responses during IV cannulation in neonates as compared to a placebo.
##plugins.themes.bootstrap3.article.details##
Copyright (c) 2025 V. Krishna Prabhath, Nuthan Sai Paruchuri, Hariprasad Dusa, Saiprasad Onkareshwar Kavthekar, Nivedita Balasaheb Patil, Harshwardhan Saiprasad Kavthekar, Nupur Balasaheb Patil
This work is licensed under a Creative Commons Attribution 4.0 International License.
Creative Commons License All articles published in Annals of Medicine and Medical Sciences are licensed under a Creative Commons Attribution 4.0 International License.
[1] Bellieni CV, Stazzoni G, Tei M, Alagna MG, Iacoponi F, et al. How painful is a heel prick or a venipuncture in a newborn? The Journal of Maternal-Fetal & Neonatal Medicine. 2016; 29(2): 202-6.
[2] Victoria NC, Murphy AZ. Exposure to early life pain: long term consequences and contributing mechanisms. Current opinion in behavioural sciences. 2016;7: 61-8.
[3] Taddio A, Katz J, Ilersich AL, Koren G. Effect of neonatal circumcision on pain response during subsequent routine vaccination. The lancet. 1997;349(9052): 599-603.
[4] Anand KS, Grunau RE, Oberlander TF. Developmental character and long-term consequences of pain in infants and children. Child and Adolescent Psychiatric Clinics of North America. 1997 ;6(4):703-24.
[5] Shah V, Taddio A, Ohlsson A. Randomised controlled trial of paracetamol for heel prick pain in neonates. Archives of Disease in Childhood-Fetal and Neonatal Edition. 1998;79(3): F209-11.
[6] Corbo MG, Mansi G, Stagni A, Romano A, Van den Heuvel J, et al. Nonnutritive sucking during heel stick procedures decreases behavioural distress in the newborn infant. Neonatology. 2000;77(3):162-7.
[7] Carbajal R, Chauvet X, Couderc S, Olivier-Martin M. Randomised trial of analgesic effects of sucrose, glucose, and pacifiers in term neonates. BMJ .1999 ;319(7222):1393-7.
[8] Blass EM. Milk-induced hypoalgesia in human newborns. Pediatrics.1997;99(6):825-9.
[9] Sarkaria E, Gruszfeld D. Assessing Neonatal Pain with NIPS and COMFORT-B: Evaluation of NICU’s Staff Competences. Pain Research and Management. 2022;8545372.
[10] Barrett T, Kent S, Voudouris N. Does melatonin modulate beta-endorphin, corticosterone, and pain threshold? Life Sciences. 2000 ;66(6):467-76.
[11] Zanardo V, Nicolussi S, Carlo G, Marzari F, Faggian D, et al. Beta endorphin concentrations in human milk. Journal of pediatric gastroenterology and nutrition. 2001;33(2):160-4.
[12] Chanville de A B, Malaty V B, Garbi A, Tosello B, Baumstarck K, et al. Analgesic effect of maternal human milk odour on premature neonates: A randomized controlled trial. Journal of Human Lactation. 2017 ;33(2):300-8.
[13] Sahoo JP, Rao S, Nesargi S, Ranjit T, Ashok C, Bhat S. Expressed breast milk vs 25% dextrose in procedural pain in neonates: a double blind randomized controlled trial. Indian Pediatrics. 2013;50: 203-7.
[14] Vohra A, Purani C, Mehariya KM, Shah B. Neonatal analgesia: Effect of sucrose solution versus breastfeeding in procedural pain. Pediatric Oncall Journal. 2017;14(4):79-81.
[15] Bhurtel R, Yadav U, Chaudhary R, Shah S, Poudel P, Pokhrel RP, Sharma S. Effect of breastfeeding on relieving pain during immunization in infant. Kathmandu University Medical Journal. 2020;18(4):376-80.
[16] Varughese PM, Pai N, Prakash M. Comparing Neonatal Pain Responses to Intravenous and Intramuscular Injections and Effect of Non-Pharmacological Measure. International Journal of Innovative Research in Medical Science. 2021;6(1):30-7.