Evaluation of breastfeeding and 30% glucose solution as analgesic measures in indigenous African term neonates

Chiabi, Andréas; Eloundou, Eugene Odi; Mah, Evelyn; Nguefack, Séraphin; Mekone, Isabelle; Mbonda, Elie

doi:10.4103/2249-4847.173269

Cited by 12 publications

(3 citation statements)

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“…PICO question comparisons that were prioritised by the NPGG in their discussions were those involving breastfeeding, oral sugar, expressed breastmilk, skin-to-skin care, and non-nutritive sucking. 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 ...…”

Section: Resultsmentioning

confidence: 99%

“…However, the NPGG had a low certainty in the superiority of breastfeeding over oral sugar ( appendix p 7 ). Narrative synthesis (n=670) revealed inconsistencies, with five (63%) of eight studies with direct comparisons suggesting breastfeeding was superior to oral sugar, 24 , 34 , 35 , 36 , 37 two (25%) showing equivalence, 38 , 39 and one (13%) inferiority to oral sugar ( appendix p 8 ). 40 Meta-analysis suggested no difference using PIPP score (−0·21 [–0·78 to 0·35]; n=346), but superiority of breastfeeding using NIPS score (−1·51 [–2·48 to −0·53]; n=182; appendix pp 15, 16 ).…”

Section: Resultsmentioning

confidence: 99%

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Development of locally relevant clinical guidelines for procedure-related neonatal analgesic practice in Kenya: a systematic review and meta-analysis

Wade

Frazer

Qian

et al. 2020

The Lancet Child & Adolescent Health

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Summary Background Increasing numbers of neonates are undergoing painful procedures in low-income and middle-income countries, with adequate analgesia seldom used. In collaboration with a multi-disciplinary team in Kenya, we aimed to establish the first evidence-based guidelines for the management of routine procedure-related neonatal pain that consider low-resource hospital settings. Methods We did a systematic review by searching MEDLINE, Embase, CINAHL, and CENTRAL databases for studies published from Jan 1, 1953, to March 31, 2019. We included data from randomised controlled trials using heart rate, oxygen saturation (SpO 2 ), premature infant pain profile (PIPP) score, neonatal infant pain scale (NIPS) score, neonatal facial coding system score, and douleur aiguë du nouveau-né scale score as pain outcome measures. We excluded studies in which neonates were undergoing circumcision or were intubated, studies from which data were unextractable, or when pain was scored by non-trained individuals. We did a narrative synthesis of all studies, and meta-analysis when data were available from multiple studies comparing the same analgesics and controls and using the same outcome measures. 17 Kenyan health-care professionals formed our clinical guideline development panel, and we used the Grading of Recommendations, Assessment, Development and Evaluation framework and the panel's knowledge of the local health-care context to guide the guideline development process. This study is registered with PROSPERO, CRD42019126620. Findings Of 2782 studies assessed for eligibility, data from 149 (5%) were analysed, with 80 (3%) of these further contributing to our meta-analysis. We found a high level of certainty for the superiority of breastfeeding over placebo or no intervention (standardised mean differences [SMDs] were −1·40 [95% CI −1·96 to −0·84] in PIPP score and −2·20 [–2·91 to −1·48] in NIPS score), and the superiority of oral sugar solutions over placebo or no intervention (SMDs were −0·38 [–0·61 to −0·16] in heart rate and 0·23 [0·04 to 0·42] in SpO 2 ). We found a moderate level of certainty for the superiority for expressed breastmilk over placebo or no intervention (SMDs were −0·46 [95% CI −0·87 to −0·05] in heart rate and 0·48 [0·20 to 0·75] in SpO 2 ). Therefore, the panel recommended that breastfeeding should be given as first-line analgesic treatment, initiated at least 2 min pre-procedure. Given contextual factors, for neonates who are unable to breastfeed, 1–2 mL of expressed breastmilk should be given as first-line analgesic, or 1–2 mL of oral sugar (≥10% concentration) as second-line analgesic. The panel also recommended parental presence during procedures with adjunctive provision of skin-to-skin care, or non-nutritive sucking when possible. Interpretation We have generated Kenya's first neonatal analgesic guidelin...

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Development of locally relevant clinical guidelines for procedure-related neonatal analgesic practice in Kenya: a systematic review and meta-analysis

Wade

Frazer

Qian

et al. 2020

The Lancet Child & Adolescent Health

View full text Add to dashboard Cite

show abstract

“…Direct breastfeeding has consistently been found to be more effective than comparator interventions, such as swaddling [ 71 , 73 ], maternal holding or SSC [ 74 , 75 , 76 , 77 , 78 ], topical anesthetics and cooling sprays [ 79 , 80 ], non-nutritive sucking [ 81 ], heel warming [ 82 ], music therapy [ 83 ], and placebo or no treatment [ 71 , 84 , 85 ]. Results are mixed when compared to sweet tasting solutions, however, direct breastfeeding has been found to be as or more effective [ 37 , 86 , 87 , 88 , 89 , 90 ]. Studies on the feeding of expressed breastmilk alone and without maternal contact report mixed results [ 72 ].…”

Section: Management Of Neonatal Painmentioning

confidence: 99%

Assessment and Management of Pain in Preterm Infants: A Practice Update

2022

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Infants born preterm are at a high risk for repeated pain exposure in early life. Despite valid tools to assess pain in non-verbal infants and effective interventions to reduce pain associated with medical procedures required as part of their care, many infants receive little to no pain-relieving interventions. Moreover, parents remain significantly underutilized in provision of pain-relieving interventions, despite the known benefit of their involvement. This narrative review provides an overview of the consequences of early exposure to untreated pain in preterm infants, recommendations for a standardized approach to pain assessment in preterm infants, effectiveness of non-pharmacologic and pharmacologic pain-relieving interventions, and suggestions for greater active engagement of parents in the pain care for their preterm infant.

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