Effect of expressed breast milk administration on pain response among newborns during heel lance procedure in a tertiary care hospital — A randomized controlled trial

Abstract

Newborn’s pain is a great challenge to health professionals as well as to parents. Newborns are especially vulnerable to pain. The primary objective was to evaluate the effectiveness of expressed breast milk administration on pain response among newborns during heel lance procedure and the secondary objective was to find out association between selected sociodemographic variables and pain response among newborns during heel lance procedure. The research approach adopted was quantitative and the design was experimental - A randomized controlled trial. Sixty newborns after 48 to 72 hours of life who came to the Shalabham newborns screening unit for metabolic screening were selected according to the inclusion criteria. Samples were selected by using block randomization with fixed block size 4 and newborns divided into two groups, experimental and control group. Allocation concealment was done by using an opaque sealed envelope. The investigator, clinical data collected from the case record of the newborns and caregiver who came with newborns to Shalabham unit. After collecting clinical data, pain was measured by NIPS score 3 minutes before heel lance procedure for getting baseline data by an observer in both the groups by an observer. The investigator knows the newborns whether included in experimental or control group. Then for the experimental group, 5 ml expressed breast milk was given through gokarnam by the investigator and routine care was given by the staff nurse. For control group routine care given by staff nurse. After 1 minute performed heel lance procedure by a staff nurse who had adequate experience in neonatal care to minimize the variation in pain during the heel lance procedure, heel lance procedure was done using all sterile precautions and blood collected in the screening card and kept for drying process. The observer assessed the pain level of newborns by using NIPS score during heel lance procedure both experimental group and control group. After 30 minutes, pain level was reassessed by observer using NIPS score on experimental and control group and recorded. Results showed that the mean pain level was significantly improved in the experimental group (p<0.00) compared to the control group. Thus, it can be concluded that expressed breast milk administration is found to be effective in reducing pain during heel lance procedures.