Analgesic effect of non-pharmacological interventions in healthy newborns: A randomised controlled study

Objectives: To assess if breastfeeding and skin-to-skin contact have an analgesic effect in newborns undergoing venepuncture and to evaluate if skin-to-skin contact together with breast feeding provides additional analgesic effect compared to skin-to-skin contact alone. Method: We conducted a prospective randomised controlled study in three maternity units in Colombo South Teaching Hospital. Sixty infants who were undergoing routine venepuncture to assess serum bilirubin levels and who fulfilled the inclusion criteria were enrolled. They were randomly assigned to 1 of 3 study groups. In group I, infants were breastfed while being held in skin-to-skin contact. In group II, babies were given skin-to-skin contact by the mother. Control group infants (Group III) were kept on a table similar to the procedure table during venepuncture, which is the standard ward procedure. Two trained observers independently measured the pain score, using Premature Infant Pain Profile (PIPP). Results: Pain scores of 20 neonates from each group were analyzed. There were no significant differences between the 3 groups in terms of demographic characteristics. Median PIPP scores of the 2 study groups were statistically significant when compared to the control group. There was no significant difference of pain score between the breast feeding with skin to skin contact and skin to skin contact groups. Conclusions: Skin-to-skin contact and breast feeding were effective in reducing the pain during venepuncture. However, breastfeeding with skin-to-skin contact did not provide additional analgesic effect compared to skin-to-skin contact alone. (Key words: pain; newborn infant; skin to skin contact) Sri Lanka Journal of Child health , 2014; 43 (3): 142-146 DOI: http://dx.doi.org/10.4038/sljch.v43i3.7373