Effects of Expressed Breast Milk on Pain Response to Tracheal Suction in Premature Infants

The present study was quasi-experimental research with a one-group crossover design aimed at investigating the effects of expressed breast milk on pain responses to tracheal suction in premature infants.  The premature infants’ behavioral responses to pain and physiological responses to pain, including heart rates and oxygen saturation were assessed. The subjects of this study were 30 premature infants who received tracheal suction and  were admitted into the Neonatal intensive care unit (NICU) between March and October, 2014. The subjects were purposively and randomly assigned in order of treatment to the experimental conditions and controlled conditions. In the experimental conditions, the infants received expressed breast milk before tracheal suction and in the controlled conditions the infants received the usual nursing care.  The Neonatal Infant Pain Scale (NIPS) was used to measure pain scores. The comparison of pain level, heart rate and oxygen saturation were analyzed using repeated measures ANOVA, Wilcoxon’s signed-rank test and the Friedman test. The results of this study showed that the pain level during tracheal suction of the subjects who received breast milk before tracheal suction was lower than that of those who received only usual nursing care with statistical significance. However, at one, three, and five minutes after tracheal suction, the pain level of the subjects for both conditions were not different. When considering heart rates, it could be seen that during and one, three, and five minutes after tracheal suction, there was no statistically significant difference between both conditions.  Finally, with regard to oxygen saturation, during and one, three, and five minutes after tracheal suction, there was no statistically significant difference between both conditions. The study findings should be utilized for clinical nursing practice guidelines on management of tracheal suction pain in premature infants.