ABSTRACT
CONTEXT: This study identifies a behavioral and nonpharmacologic means of preventing newborn pain. OBJECTIVE: To determine whether breastfeeding is analgesic in newborn infants undergoing heel lance-a routine, painful, hospital procedure. DESIGN: A prospective, randomized, controlled trial. SETTING: Hospital maternity services at Boston Medical Center, Boston, Massachusetts, and Beverly Hospital, Beverly, Massachusetts. PARTICIPANTS: A random sample of 30 full-term, breastfed infants. INTERVENTIONS: Infants in the intervention group were held and breastfed by their mothers during heel lance and blood collection procedures for the Newborn Screening Program Blood Test. Infants in the control group experienced the same blood test while receiving the standard hospital care of being swaddled in their bassinets. OUTCOMES MEASURES: Crying, grimacing, and heart rate differences were analyzed between the breastfeeding and the control infants before, during, and after blood collection. RESULTS: Crying and grimacing were reduced by 91% and 84%, respectively, from control infant levels during the blood collection. Heart rate was also substantially reduced by breastfeeding. CONCLUSIONS: Breastfeeding is a potent analgesic intervention in newborns during a standard blood collection.
Subject(s)
Breast Feeding/psychology , Infant Behavior , Pain/psychology , Blood Specimen Collection/adverse effects , Blood Specimen Collection/methods , Crying/psychology , Feeding Behavior/physiology , Feeding Behavior/psychology , Female , Heart Rate , Heel , Humans , Infant, Newborn , Male , Pain/etiology , Pain/prevention & control , Prospective Studies , Punctures/adverse effectsABSTRACT
OBJECTIVE: The purpose of this study was to identify the least painful circumcision method. STUDY DESIGN: The infants were circumcised with either the Mogen or the Gomco procedure and were given a sweetened pacifier or a pacifier dipped in water. All infants had a eutectic mixture of local anesthetic cream applied before circumcision. The duration of the crying and grimacing were measured. RESULTS: The Gomco procedure took 1.9 times longer to complete. Infants who were circumcised with the Mogen procedure cried and grimaced far less than infants who were circumcised with the Gomco procedure (P =.0001). Sucrose on a pacifier was far more analgesic than water on a pacifier for infants in the Gomco group. CONCLUSION: On the basis of these and other findings on pain prevention and amelioration, we recommend that a local anesthetic be administered in advance of circumcision and that the Mogen procedure be used, unless contraindicated. We also recommend that infants be given a sweetened pacifier before, during, and after circumcision if the Gomco method is used.
