Comparative Study between Analgesic Effect of Breast Feeding and Oral Sucrose in Full Term Newborns

Abstract

Introduction: Non-pharmacological measures like oral sucrose and breast feeding are recommended modalities to treat acute procedural pain in newborns. Birth dose of hepatitis B vaccine exposes newborns to pain of intramuscular injection which is preventable. The present study has been carried out to assess the severity of pain and the effect of breast feeding and oral sucrose. Aim: To study the pain profile and the effects of breast feeding and oral sucrose solution on pain, in full term newborns. Materials and Methods: A prospective interventional case control study was carried out in the Department of Paediatrics and Post natal ward of Obstetrics and Gynaecology associated Gandhi Memorial Hospital. Randomly selected 150 full term vaginally delivered healthy newborns were enrolled in the study. Recruited newborn infants were grouped into three arms and each arm had 50 newborns. Group I as control group, and group II and III as intervention groups. A 1 mL of 25% oral sucrose solution was given two minutes before the vaccination in group II. Breast feeding was started 2 minutes before vaccination and continued till the end of injection in group III. The primary outcome of the study was to assess pain by Premature Infant Pain Profile (PIPP) score. PIPP score was compared by using ANOVA test and student's t-test was used to compare continuous variables and two tailed Fisher-exact test or Chisquare test was used to compare categorical variables. The critical levels of significance of the results were considered at 0.05 levels i.e., p<0.05 was considered significant. Results: Mean PIPP scores were lower in group III (8.36) than in group II (11.06) and difference was significant (p<0.0001). The pain profile of newborns ranged from 9 to 18 with mean of 14.26 in group I, from 5 to 12 with mean of 11.06 in group II and from 1 to 12 with mean of 8.36 in group III respectively. Conclusion: Intramuscular injection produces moderate to severe pain response in group I and mild to moderate pain responses in group II and III. Breast feeding provides superior analgesia to oral sucrose and reduces moderate to severe painful response to mild to moderate grade in term newborns.

Keywords

• intramuscular injection
• pain
• vaccination