title: Analgesic effects of breast-feeding or pacifier use with maternal holding in term infants.
abstract: OBJECTIVE
  First, to compare analgesic effects of breast-feeding versus pacifier use in newborn infants undergoing blood collection via heel sticks. Second, to compare analgesic effects of pacifier use with maternal holding versus nonmaternal holding.
  
  
  METHODS
  A prospective, randomized, controlled trial.
  
  
  METHODS
  Normal newborn nursery at academic teaching hospital.
  
  
  METHODS
  Full-term breast-feeding infants scheduled for routine newborn screening blood test via heel stick (n = 96). Interventions.-Infants randomized to 3 groups for analgesia: 1) breast-feeding, 2) pacifier use while held by mothers, 3) pacifier use while held by research assistants (nonmothers).
  
  
  METHODS
  Primary outcome was crying (percent of infants who cried during the procedure and mean percent of procedure time that infants cried). Secondary outcomes were physiologic measures.
  
  
  RESULTS
  Fewer breast-feeding infants cried than infants using a pacifier while held by nonmothers both during the procedure (69% vs 100%, P < .01) and after the procedure (28% vs 60%, P = .03). Those infants crying during the procedure cried for less time if held by their mothers either breast-feeding (33%, P < .01) or using a pacifier (45%, P = .03) than those using a pacifier while being held by nonmothers (66%).
  
  
  CONCLUSIONS
  Breast-feeding is more analgesic than pacifier use with nonmaternal holding. Maternal holding with either breast-feeding or pacifier use is more analgesic than nonmaternal holding with pacifier use, suggesting that maternal holding itself has an analgesic effect. Breast-feeding and maternal holding should be considered as pain-control measures for the neonate during heel-stick procedures.
authors.affiliation: Loma Linda University Children's Hospital, Loma Linda, CA, USA.
authors.forename: Raylene M
authors.initials: RM
authors.lastname: Phillips
authors.forename: Caroline J
authors.initials: CJ
authors.lastname: Chantry
authors.forename: Michael P
authors.initials: MP
authors.lastname: Gallagher
mesh_terms: D000698:Analgesia; D001800:Blood Specimen Collection / Q000009:adverse effects*; D001942:Breast Feeding; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009034:Mother-Child Relations; D041361:Pacifiers; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D047929:Term Birth