Effects of breastfeeding on pain relief in full-term newborns.
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.


METHODS
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.


RESULTS
The primary outcomes were Neonatal Facial Actions (Neonatal Facial Activity Coding System-upper face), sleep-wake state. Heart rate was considered as an index of arousal. Sucking frequency was only evaluated in the experimental group. Compared with the control group, the experimental group had significantly lower, Neonatal Facial Activity Coding System and sleep-wake state scores and heart rates changes. In the experimental group sucking frequency was highest during the first 5 minutes of breastfeeding before the procedure.


CONCLUSIONS
This study innovates from earlier studies in 4 respects: the different phases of the procedure were evaluated separately; the breastfeeding intervention covered the period from 5 minutes before the blood collection until the end of recovery; sleep-wake state was fully assessed (not merely crying) and the sucking frequency in the experimental group was assessed during the procedure. The conclusion was that breastfeeding was effective in reducing pain caused by blood collection for newborn screening.
University of São Paulo at Ribeirão Preto College of Nursing, WHO Collaborating Centre for Nursing Research Development, Brazil. drileite@eerp.usp.br
Adriana Moraes
AM
Leite
Maria Beatriz Martins
MB
Linhares
Janice
J
Lander
Thaíla Corrêa
TC
Castral
Cláudia Benedita
CB
dos Santos
Carmen Gracinda
CG
Silvan Scochi
D001942:Breast Feeding; D005149:Facial Expression; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010146:Pain / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control*; D011677:Punctures / Q000009:adverse effects*; D012372:ROC Curve; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D012890:Sleep / Q000502:physiology; D018709:Statistics, Nonparametric; D013391:Sucking Behavior / Q000502:physiology; D014851:Wakefulness / Q000502:physiology