Abstract
This study aimed to evaluate the efficacy of breast milk odor either alone or in combination with breast milk taste (via syringe-feeding) to alleviate neonates’ biobehavioral responses to pain during heel-prick procedures. This prospective randomized controlled trial recruited 114 neonates by convenience sampling from a newborn unit of a medical center in Taiwan. Neonates were randomly assigned to three groups: control (gentle touch + human voice), control + breast milk odor, and control + breast milk odor + breast milk taste. Heart rate, oxygen saturation, and voice recordings of crying were measured across heel-prick procedures: baseline, no stimuli (stage 0); during heel prick (Stages 1–4); and recovery (Stages 5–10). Generalized estimating equations and Kaplan–Meier survival analysis compared differences in changes between groups for heart rate, oxygen saturation, and time to crying cessation. Changes in mean heart rate and oxygen saturation in neonates receiving breast milk odor or breast milk odor + breast milk taste were significantly less than those at the corresponding stage for the control group. Among neonates receiving breast milk odor or breast milk odor + breast milk taste, hazard rate ratios for crying cessation were 3.016 and 6.466, respectively. Mother’s breast milk olfactory and gustatory interventions could stabilize the biobehavioral responses to pain during heel prick procedures in neonates.
Highlights
Healthy neonates can undergo more than five painful procedures in a hospital’s newborn unit [1]
Preventing the changes of biobehavioral responses to painful procedures in neonates is a moral obligation for clinicians [1,5]
Neonatal pain can be observed through biological responses and behavioral responses [12], which can be employed as indicators of pain when assessing the effect of analgesic interventions [8]
Summary
Healthy neonates can undergo more than five painful procedures in a hospital’s newborn unit [1]. Preventing the changes of biobehavioral responses to painful procedures in neonates is a moral obligation for clinicians [1,5]. An understanding of infant pain continues to improve pain management, management of the changes of biobehavioral responses to short-term painful procedures has not been a focus [6]. A shift in the focus of neonatal research and clinical practice to advance management of short-term procedural pain could improve care quality [10] and promote long-term infant health and wellbeing [11]. Oral sucrose or pacifier sucking are not appropriate interventions for pain relief in breastfed newborns. The BFHI policy guided us to use BM different sensory stimuli to prevent the changes of biobehavioral response to painful procedures
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