The effect of inhaling mother’s breast milk odor on the behavioral responses to pain caused by hepatitis B vaccine in preterm infants: a randomized clinical trial

Abstract

Background Nowadays, it is generally assumed that non-pharmacologic pain relief in preterm infants is an important measure to consider. Research findings suggest that familiar odors have soothing effects for neonates. The aim of this study was to compare the effect of maternal breast milk odor (MBMO) with that of another mother’s breast milk odor (BMO) on the behavioral responses to pain caused by hepatitis B (HB) vaccine injection in preterm infants. Methods This single-blind randomized clinical trial was performed over the period between February 2019 and March 2020 in the neonatal intensive care unit of Babol Rouhani Hospital, Iran. Ninety preterm infants, who were supposed to receive their HB vaccine, were randomly assigned into three groups: MBMO (A), another mother’s BMO (B), and control with distilled water(C). Oxygen saturation (SaO2), blood pressure (BP) and heart rate (HR) were recorded for all participants through electronic monitoring. In addition, premature infant pain profiles (PIPP) were determined through video recording for all three groups during intervention. The chi-square, ANOVA and ANCOVA were used for analyzing the data, and P < 0.05 was considered significant in this study. Results No significant differences were found between the three groups in mean ± SD of HR, BP, and Sao2 before the intervention (P > 0.05). After the intervention, however, the means for heart rate in groups A, B, and C were 146 ± 14.3, 153 ± 17.5 and 155 ± 17.7, respectively (P = 0.012). Moreover, the means for PIPP scores in groups A, B and C were 6.6 ± 1.3, 10 ± 2, and 11.4 ± 1.9, respectively (P < 0.001). There was no significant difference found between groups in their means of SaO2, systolic and diastolic blood pressure after the intervention (P > 0.05). Conclusions The results indicate that stimulation with MBMO is effective in reducing pain in preterm infants; therefore, it can be postulated that this technique can be considered in less invasive procedures such as needling. Trial registration IRCT, IRCT20190220042771N1. Registered 18 May 2019- Retrospectively registered,

Efficacy of Breast Milk Olfactory and Gustatory Interventions on Neonates’ Biobehavioral Responses to Pain during Heel Prick Procedures

“…Neonatal pain can be observed through biological responses (heart rate and oxygen saturation) and behavioral responses (crying, changes in facial expression, and changes in body movements) [12], which can be employed as indicators of pain when assessing the effect of analgesic interventions [8]. The use of non-pharmacologic interventions in pain management in infants has become more common due to their availability, accessibility, cheapness, and effectiveness [13][14][15][16][17].…”

Non-Pharmacological Management for Vaccine-Related Pain in Children in the Healthcare Setting: A Scoping Review

“…Breast milk is a natural pain reliever containing beta endorphins, especially colostrum, which contains twice the concentration of beta endorphins as plasma. 37 In a randomized controlled study, 38 breast milk, another mother’s breast milk, and distilled water were placed 3 cm in front of the nose of premature infants. Compared with the other two groups, there were statistically significant differences in heart rates and pain scores in breast milk group.…”

The effect of breastfeeding, breast milk odour and mother's heartbeat sound on pain level in newborns: A randomized trial

“…Studies with a control group that did not use any non‐pharmacological methods reported lower pain scores for newborns in the breast milk odour group than those in the control groups (Amiri Shadmehri et al, 2020; Sajjadi et al, 2017). One study compared the effects of own mother's breast milk odour and the odour of another mother's milk on pain in preterm infants with hepatitis B vaccine and reported a lower pain profile score (PIPP) for those who smelled their own mother's milk (Rad et al, 2021).…”

“…Vital signs are included in the physiological parameters used to evaluate stress and pain (Als et al, 1996(Als et al, , 2005. However, studies of pain have found a significant difference in vital data such as heart rhythm and SPO2 (Chirico et al, 2017;Kahraman et al, 2020;Sajjadi et al, 2017;Sarhangi et al, 2021;Wu et al, 2021), but no significant difference in vital data was found in some studies (Alemdar & Tüfekci, 2017;Rad et al, 2021;Taplak & Bayat, 2021) Heart rate and SPO2 values can change according to the sampling criteria or material method of the study.…”