title: Comparing the effect of swaddling and breastfeeding and their combined effect on the pain induced by BCG vaccination in infants referring to Motahari Hospital, Jahrom, 2010-2011.
abstract: OBJECTIVE
  Despite the clinical importance of pain, many neonates are subjected to numerous painful invasive procedures and their complications as part of their care. This study has been designed to investigate the effect of swaddling and breastfeeding, and their combined effect on the pain induced by BCG vaccination in healthy term infants.
  
  
  METHODS
  This randomized double-blind intervention study was performed on 131 healthy term neonates in Motahari Hospital of Jahrom. The samples were randomly assigned into three intervention groups and a control group. The infants in the swaddled group were swaddled 2 minutes before and 2 minutes after vaccination. The infants in the breastfed group were breastfed within 45 minutes before vaccination. The infants in the combination group were both breast fed before and swaddled within vaccination but the infants in the control group were vaccinated without any intervention. Heart rate and oxygen saturation level of neonates were recorded in the 3 phases of: baseline, injection and 2 minutes after injection. Furthermore, the neonates' faces were recorded using a video camera. Then pain intensity was measured by Neonatal Facial Coding System (NFCS). Mean Score of pain intensity and physiological responses of subjects were statistically analyzed using non parametrical Kruskal-Wallis test and Mann-Whitney.
  
  
  RESULTS
  The mean of pain intensity (NFCS) and changes in the heart rate at injection time to the baseline in the three intervention groups in comparison with the control group showed statistically significant difference (p=0.003 and p=0.002 respectively). However changes in blood oxygen saturation level, were not statistically significant difference between four groups.
  
  
  CONCLUSIONS
  Regarding to the significant impact of both breastfeeding and swaddling on the pain reduction of vaccination, it is recommended to take benefit of these two safe and available non-pharmacological methods in order to relief pain during painful procedures.
authors: Fatemeh (P.B.U.H) College of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
authors: Fatemeh
authors: F
authors: Hashemi
authors: Fatemeh (P.B.U.H) College of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran. Electronic address: taheri.leila@ymail.com.
authors: Laila
authors: L
authors: Taheri
authors: Fatemeh (P.B.U.H) College of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
authors: Fariba
authors: F
authors: Ghodsbin
authors: Neonatalogy Research Center, Department of Pediatrics, Namazee Hospital, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
authors: Narjes
authors: N
authors: Pishva
authors: Department of Dental Public Health, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
authors: Mehrdad
authors: M
authors: Vossoughi
mesh_terms: D001500:BCG Vaccine / Q000008:administration & dosage*; D001512:Bedding and Linens / Q000009:adverse effects*; D001942:Breast Feeding; D004311:Double-Blind Method; D006801:Humans; D007224:Infant Care / Q000379:methods*; D007231:Infant, Newborn; D010146:Pain / Q000503:physiopathology*; D014611:Vaccination / Q000009:adverse effects
chemical_list: D001500:BCG Vaccine
keywords: BCG vaccine; Breastfeeding; Neonates; Pain; Swaddling