Expressed breast milk for procedural pain in preterm neonates: a randomized, double-blind, placebo-controlled trial.
OBJECTIVE
To determine whether expressed breast milk (milk) reduces procedural pain associated with heel lancing in preterm neonates.


METHODS
In this placebo-controlled trial, preterm neonates received 5 mL of distilled water as placebo (water, n = 44), 25% glucose water (glucose, n = 39) or milk (n = 40). Heel lancing was performed 2 min later. The primary outcome was the duration of first cry after lancing.


RESULTS
Participants had similar baseline demographic and clinical characteristics. There was a significant difference in the median duration of first cry among the groups: water = 70.5 sec [interquartile range (IQR) = 5.5-104.5]; glucose = 2.0 sec (IQR = 0.0-45.0); milk = 29.5 sec (IQR = 0.0-65.0). Specifically, the duration of first cry was significantly shorter in the glucose group compared with the water group (Bonferroni adjustment, p = 0.011). Pain scores were significantly lower in the glucose and milk groups compared with the water group 1, 2 and 3 min after heel lancing (p < 0.05).


CONCLUSIONS
Although milk did not significantly reduce crying time, our finding that pain scores were significantly lower in the milk group suggests that milk may reduce pain associated with heel lancing in preterm neonates.
Division of Neonatology, Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Mei-Chen
MC
Ou-Yang
I-Lun
IL
Chen
Chih-Cheng
CC
Chen
Mei-Yung
MY
Chung
Feng-Shun
FS
Chen
Hsin-Chun
HC
Huang
D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D008895:Milk, Human; D010146:Pain / Q000209:etiology* / Q000517:prevention & control*; D010147:Pain Measurement; D011677:Punctures / Q000009:adverse effects*