Breast Milk, Glucose, or Maternal Holding: Which Works Best to Promote Infant Analgesia? :

Reducing infant pain and discomfort is a priority for all of us in caring for babies in newborn nurseries who require blood draws, circumcisions, and other potentially painful procedures. But what is the best way to do this non-pharmacologically?  Do we give the baby breastmilk, glucose, or would maternal holding be best?  To answer that question, Bembich et al. (10.1542/peds.2017-3416) conducted a randomized trial dividing 80 infants into four groups to undergo a heel stick blood draw.  Group 1 got a glucose solution on a changing table; group 2 received breastmilk on the table; group 3 received glucose solution in their mother’s arms and group 4 were simply breastfed by their mother.  Response to pain was tracked using near-infrared spectroscopy along with facial pain expression.  The results were somewhat surprising in that the best results were obtained in the group receiving glucose and in their mother’s arms, although breastfeeding in mother’s arms also had a strong analgesic effect.  This is a sweet study in that it demonstrates that when it comes to reducing infant pain and discomfort with procedures, maternal contact with baby with or without breastmilk is the preferred method of analgesia.  You won’t find this article a pain at all to read—and it may change how you bring pain relief to your youngest patients.  Do you agree with the results?  Share with us either way by posting a response to this blog, entering a comment on our website with the article or commentary, or simply sharing your thoughts on our Facebook or Twitter pages.