Analgesic effect of expressed breast milk in procedural pain in term neonates: a randomized, placebo‐controlled, double‐blind trial

Abstract

Upadhyay A, Aggarwal R, Narayan S, Joshi M, Paul VK, Deorari AK. Analgesic effect of expressed breast milk in procedural pain in term neonates: a randomized, placebo-controlled, double-blind trial. Acta Paediatr 2004; 93: 518-22. Stockholm. ISSN 0803-5253 Aim: To assess the effectiveness of expressed breast milk (EBM) in reducing pain due to venepuncture, in term neonates, as measured by behavioural and physiological observations. Methods: This randomized, placebo-controlled, double-blind trial involved 81 full-term neonates, up to 4 wk of postnatal age, who needed venepuncture for blood investigations. Two minutes before the venepuncture, in the intervention arm, 40 babies received 5 ml of EBM, while 41 babies in control group received 5 ml of distilled water (DW) as placebo. Two observers who were blinded to the intervention recorded the physiological (heart rate and oxygen saturation) and behavioural parameters [duration of crying and modified Neonatal Facial Coding Scores (NFCS)] after the venepuncture. Results: There was no difference in the baseline characteristics of the neonates in the two groups. The duration of crying was significantly shorter in babies fed EBM [median 38.5 s, interquartile range (IQR) 9.5-57.5 s] than in those fed DW (median 90 s, IQR 28-210 s). The mean duration of crying in EBM group was shorter by 70.7 (95% confidence interval 36.6-104.9) s. The modified NFCS at 0, 1 and 3 min was significantly lower (p < 0.01) in the EBM than in the DW group. The change in heart rate and oxygen saturation was significantly lower in the EBM group and returned to baseline values sooner than in the DW group.Conclusion: Feeding 5 ml of EBM before venepuncture is effective in reducing symptoms due to pain in term neonates.

Liking and the orosensory perception of food in a stress vs. rest condition in overweight and normal weight participants

“…sensory cues to high energy density, can mitigate effects of stress via the brain's reward system (Edward, 2006). For example, in animals and human infants, the ingestion of sweet and fatty foods, including milk, alleviates crying and other behavioral signs of distress (Blass, Shide, & Weller, 1989;Upadhyay et al, 2004). This effect depends on sweet taste rather than calories, as non-nutritive sweeteners reduced crying too (Barr et al, 1999).…”

Enteral Docosahexaenoic Acid Reduces Analgesic Administration in Neonates Undergoing Cardiovascular Surgery

“…It is well known that human milk has an analgesic effect [35] ; there are several mechanisms that might provide such effect as the sweetness (presence of lactose), the higher concentration of tryptophan compared with formula, a precursor of melatonin, which increase the concentration of beta endorphins [36] , but also contains DHA with anti-inflammatory properties. Although DHA content in human milk from Mexican women range from 0.17 to 0.26% of total fatty acids [37,38] , similar to those detected in women from the US and other countries where dietary DHA consumption is lower than recommended, the volume of human milk was adjusted as a confounding factor because the DHA group tended to receive more volume.…”

Studi Komparatif Pemberian Air Susu Ibu (ASI) dan Glukosa 30% terhadap Respon Nyeri Neonatus yang Dilakukan Tindakan Invasif di Rumah Sakit Abdul Moeloek Provinsi Lampung

“…Sehingga diisimpulkan dari penelitian ini bahwa ASI oral signifikan menurunkkan nyeri setelah screening ROP. Sama halnya dengan penelitian yang dilakukan oleh Upadhyay et al, (2004) meneliti efek analgesik ASI pada prosedural nyeri pada neonatus cukup bulan, dilaksanakan pada 81 neonatus cukup bulan, sampai 4 minggu usia postnatal, yang membutuhkan pungsi vena untuk pemeriksaan darah. Dua menit sebelum pungsi vena, pada kelompok intervensi 40 bayi menerima 5 ml ASI, sedangkan 41 bayi dalam kelompok kontrol menerima 5 ml air suling sebagai plasebo, hasilnya adalah durasi menangis secara signifikan lebih pendek pada bayi yang diberi ASI, perubahan denyut jantung dan saturasi oksigen secara signifikan lebih rendah pada kelompok ASI, sehingga disimpulkan ASI 5 ml sebelum pungsi vena efektif dalam mengurangi gejala akibat nyeri pada neonatus cukup bulan pvalue<0,01.…”