Functional neuroimaging of breastfeeding analgesia by multichannel near-infrared spectroscopy.
BACKGROUND
Newborns perceive pain, and several non-pharmacologic analgesic methods have been used during painful procedures. Activation of the neonatal somatosensory cortex, in association with a painful procedure without analgesia, has been demonstrated by two-channel near-infrared spectroscopy (NIRS).


OBJECTIVE
To evaluate both cortical and behavioural responses of healthy term newborns to a painful procedure during two non-pharmacologic analgesic interventions, i.e. glucose solution and breastfeeding.


METHODS
The effects of glucose and breastfeeding on pain-associated neonatal cortical activity were studied in two groups (n = 30) by multichannel NIRS during a heel prick. Cortical activation was identified by variations in oxygenated haemoglobin. Neonatal pain expression was assessed by a validated scale.


RESULTS
No significant variations in cortical activity emerged using glucose solution, whereas breastfed newborns showed widespread cortical activation. Breastfed neonates showed significantly less behavioural pain expression.


CONCLUSIONS
Glucose is associated with no significant cortical activation and may interfere with pain-associated response at the cortical level. Conversely, breastfeeding analgesia is associated with generalized cortical activation and may act by multisensory stimulation, possibly overwhelming pain perception.
Division of Neonatology, Institute for Maternal and Child Health-IRCCS 'Burlo Garofolo', Trieste, Italy.
Stefano
S
Bembich
Riccardo
R
Davanzo
Pierpaolo
P
Brovedani
Andrea
A
Clarici
Stefano
S
Massaccesi
Sergio
S
Demarini
D000284:Administration, Oral; D000698:Analgesia / Q000379:methods*; D001942:Breast Feeding; D005260:Female; D059907:Functional Neuroimaging / Q000379:methods*; D005947:Glucose / Q000627:therapeutic use; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010146:Pain / Q000503:physiopathology; D010147:Pain Measurement / Q000379:methods; D058748:Pain Perception / Q000502:physiology; D010865:Pilot Projects; D013003:Somatosensory Cortex / Q000503:physiopathology*; D019265:Spectroscopy, Near-Infrared / Q000379:methods*; D016896:Treatment Outcome
D005947:Glucose