Breast Milk Odor Research Articles

The Effect of Breast Milk Odor on the Pain and Stress Levels of the Newborn During the Endotracheal Suction Procedure.

Objective: The study aimed to determine the effect of the breast milk odor on the pain and stress levels of the newborn during the endotracheal suction procedure. Method: The study was conducted in the randomized-controlled experimental design at the neonatal intensive care unit of the hospital in eastern Turkey between March 2022 and December 2023. The study population included newborns at the 37th to 41st gestational weeks who were receiving mechanical ventilation treatment in the neonatal intensive care unit of a hospital in eastern Turkey. All newborns who met the inclusion criteria during the data collection phase were included in the study. The study was completed with 88 newborns (44 in the intervention group and 44 in the control group). The Newborn Introductory Information Form, ALPS-Neo Newborn Pain and Stress Assessment Scale, and follow-up form were used to collect the study data. The breast milk odor of the mothers of the newborns was used as the intervention group in the study. The mothers of the newborns were contacted to obtain breast milk, and the information was obtained from the mother on the day of the procedure. One milliliter of breast milk was taken and dropped into a sterile sponge, and it was held 10 cm away from the baby's nose from 5 minutes before to 5 minutes after endotracheal suction. A routine endotracheal suction process was performed in the control group. Ethical principles were followed in the study. Results: We found that the intervention group's pain and stress score averages were lower than the control group during and after the endotracheal suction procedure (p < 0.05). Conclusion: We found that the breast milk odor reduced the pain, stress levels, and crying duration of newborns during the endotracheal suction process.

Comparing the effect of aromatherapy with breast milk, Lavandula stoechas, and Rosa damascena on venipuncture pain in preterm infants.

Since preterm infants frequently undergo painful diagnostic and therapeutic procedures, pain management, especially through non-pharmacological methods, will be extremely beneficial. Accordingly, the present study aimed to compare the effects of aromatherapy with breast milk, Lavandula stoechas, and Rosa damascena on venipuncture pain in preterm infants. In this interventional study, preterm infants were randomly divided into four groups of aromatherapy with breast milk (25 infants), Lavandula stoechas (25 infants), Rosa damascena (25 infants), and sham (25 infants). One minute before, during, and two minutes after venipuncture, the Neonatal Infant Pain Scale (NIPS) as well as heart rate and SPO2 were measured. The results indicated that pain intensity was significantly lower during and after venipuncture in all the aromatherapy methods compared with the sham group (P<0.001). Breast milk odor decreased the pain more than the other two odors during and after venipuncture (P<0.001); however, there was no significant difference between Lavandula stoechas and Rosa damascena (P=0.94). SPO2 was significantly higher in infants in the Lavandula stoechas (P<0.001) and Rosa damascena (P=0.03) groups compared with the sham infants. All three aromatherapy methods were effective in decreasing preterm infants' venipuncture pain. Since no study on the effect of aromatherapy with Rosa damascena was found in this regard, the effectiveness of aromatherapy with Rosa damascena is of great importance, and future studies are recommended to analyze this topic in greater depth.

Comparative Efficacy of Breastfeeding or Feeding of Breast Milk on Blood Sampling Pain Relief in Full-Term Neonates: A Systematic Review and Meta-Analysis.

Objectives: To evaluate the efficacy of breastfeeding or feeding of breast milk in reducing blood sampling pain in full-term neonates by comparing with other intervention measures. Methods: Related literature was searched from PubMed, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials (Central). Only randomized controlled trials (RCTs), which reported the effect of breastfeeding or feeding of breast milk on blood sampling pain in full-term neonates, were eligible. The primary outcome was set as pain score on scales, and the secondary outcomes as physiological and behavioral indicators. The risk of bias in included studies was assessed by the Cochrane Collaboration's tool. Data analysis was performed using RevMan 5.4.1. Main Results: A total of 17 RCTs were included. Breastfeeding showed a stronger effectiveness in reducing blood sampling pain, compared with nonintervention, placebo, mother's holding, breast milk odor, mother's heartbeat, music therapy, skin-to-skin, and Eutectic Mixture of Local Anesthetics ointment. However, the efficacy of glucose or sucrose (12.5%-30% concentration) seems better than breastfeeding. When compared with other interventions, feeding of breast milk yielded different results. Its effect was only stronger than placebo (sterile water or distilled water), massage, or nonintervention. Conclusions: Breastfeeding might be effective for alleviating blood sampling pain in full-term neonates. Its effect is second only to that of glucose/sucrose. The efficacy of feeding of breast milk in reducing blood sampling pain in full-term neonates might not be guaranteed.

The Effects of Pleasant Odors on Transition From Gavage to Oral Feeding in Preterm Infants: A Systematic Review and Meta-analysis

Background: Gavage feeding is associated with adverse effects, such as irritations in the mouth, hyperactivity, problems in gag reflex, bradycardia, and the parents’ unacceptance. Accordingly, it is essential to undertake a comprehensive review of the effects of breast milk and other pleasant odors that may reduce the transition time from gavage to oral feeding in preterm infants. Objectives: Aim of review is to compare of effects of breast milk and other pleasant odors with the control group on the transition from gavage to oral feeding in preterm infants. Methods: In this systematic review, online English databases, such as PubMed, Scopus, ISI Web of Science, and Cochrane Library were systematically searched without any time limitation up to February 10, 2022. The modified Jadad scale was also used to assess the quality of the articles. The inclusion criteria comprised all clinical trials evaluating the effect of aromatherapy on odors on the transition from gavage to oral feeding in preterm infants. Results: 8 studies were assessed with the effects of aroma inhalation on the transition from gavage to oral feeding. Meta-analysis of these studies showed that preterm infants transitioned from tube feeding (gavage) to oral feeding earlier in the groups stimulated by pleasant odors (standardized mean difference [SMD]=₋0.47, 95% CI, ₋0.64%, ₋0.3%, heterogeneity, P=0.32; I2=13%, 8 trials) and odor of breast milk (SMD=₋0.61, 95% CI, ₋0.64%, ₋0.31%, heterogeneity, P=0.85, I2=0%, 6 trials) in comparison to the control group. Conclusions: Our meta-analysis supports using breast milk and other pleasant odors as a safe and noninvasive way of reducing the transition time from gavage to oral feeding in preterm infants. Health providers should use effective and family-friendly interventions to care for their premature infants.

The effects of breast milk odor on the physiological and behavioral responses caused by venipuncture pain in term infants: A clinical trial study.

Pain management is very important for infants who are unable to express it verbally. Pain control is one of the nursing actions and part of their duties. This study attempted to determine the effects of breast milk odor on the physiological and behavioral responses caused by venipuncture pain in full-term infants at an educational hospital. This randomized clinical trial study was carried out on 3-5 days' term and healthy babies with a gestational age of 34 weeks and later in the 9-Day Hospital of Torbet Heydariyeh, Iran, 2021. The sample size, taking into account the possibility of a 10% dropout of samples included 20 babies for each group and a total of 40 babies were selected by convenience sampling. To collect data, a checklist of demographic characteristics, a registration form for physiological responses, and the modified behavioral pain scale were used. The results of this study showed that breast milk odor has a positive effect on behavioral responses (P < 0.001) and also a significant relationship was observed between the effects of breast milk odor and physiological responses percentage of oxygen uptake and pulse (P < 0.001). However, no significant relationship was observed between breast milk odor and breathing variables (P > 0.05). According to the results, olfactory stimulation with breast milk during venous blood sampling showed positive effects on physiological responses and pain reduction in infants. Therefore, it is recommended to use soothing stimuli such as the smell of breast milk during painful procedures in babies.

Effect of Mothers' Voice Recorded, Breast Milk Odor on Preterm Infants’ Pain and Comfort Response during Peripheral Cannulation

Effect of Mothers' Voice Recorded, Breast Milk Odor on Preterm Infants’ Pain and Comfort Response during Peripheral Cannulation

Effect of Olfactory Stimulation with Breast Milk on Pain Responses to Heel Stick in Premature Infants: A Randomized Controlled Trial.

Purpose: This study aimed to evaluate the effect of breast milk olfactory stimulation on pain response in premature infants during heel stick tests. Methods: A quasi-experimental randomized controlled trial was conducted in the neonatal intensive care unit of a tertiary-level hospital in Seoul, Korea. A breast milk group was provided olfactory stimulation with breast milk 30 seconds before the start of heel stick sampling, and a control group underwent heel stick sampling without olfactory stimulation. To evaluate infants' pain response, the heel stick procedure was video recorded, and pain response was assessed separately by two blinded research assistants using the Premature Infant Pain Scale (PIPS) through behavioral response, heart rate on physiological monitoring, and blood oxygen saturation on pulse oximetry through the video recording. Results: Forty-eight premature infants (gestational age, within 28-37 weeks, n = 24; control) were included in this study. The pain scores of the breast milk group were significantly lower than those of the control group (z = -2.04, p = 0.021). Conclusion: Breast milk odor may reduce pain in premature infants during heel stick tests.

Efficacy of Breast Milk Olfactory and Gustatory Interventions on Neonates' Biobehavioral Responses to Pain during Heel Prick Procedures.

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.

Breastmilk as a Multisensory Intervention for Relieving Pain during Newborn Screening Procedures: A Randomized Control Trial.

The study aim was to explore the effects of multisensory breastmilk interventions on short-term pain of infants during newborn screening. This is a randomized controlled trial. A total of 120 newborns were recruited and assigned by randomization to one of three treatment conditions: Condition 1 = routine care (gentle touch + verbal comfort); Condition 2 = breastmilk odor + routine care; or Condition 3 = breastmilk odor + taste + routine care. Pain was scored with the Neonatal Infant Pain Scale (NIPS). Data were collected from video recordings at 1 min intervals over the 11 phases of heel sticks: phase 1, 5 min before heel stick without stimuli (baseline); phase 2 to phase 6 (during heel stick); and phase 7 to phase 11 (recovery). Generalized estimating equations compared differences in pain scores for newborns over phases among the three conditions. Compared with the routine care, provision of the odor and taste of breastmilk reduce NIPS scores during heel sticks (B = −4.36, SE = 0.45, p < 0.001 [phase6]), and during recovery (B = −3.29, SE = 0.42, p < 0.001 [phase7]). Our findings provide new data, which supports the use of multisensory interventions that include breastmilk odor and taste in combination with gentle touch and verbal comfort to relieve pain in infants undergoing newborn screening.

The effect of inhaling mother\u2019s breast milk odor on the behavioral responses to pain caused by hepatitis B vaccine in preterm infants: a randomized clinical trial

BackgroundNowadays, it is generally assumed that non-pharmacologic pain relief in preterm infants is an important measure to consider. Research findings suggest that familiar odors have soothing effects for neonates. The aim of this study was to compare the effect of maternal breast milk odor (MBMO) with that of another mother’s breast milk odor (BMO) on the behavioral responses to pain caused by hepatitis B (HB) vaccine injection in preterm infants.MethodsThis single-blind randomized clinical trial was performed over the period between February 2019 and March 2020 in the neonatal intensive care unit of Babol Rouhani Hospital, Iran. Ninety preterm infants, who were supposed to receive their HB vaccine, were randomly assigned into three groups: MBMO (A), another mother’s BMO (B), and control with distilled water(C). Oxygen saturation (SaO2), blood pressure (BP) and heart rate (HR) were recorded for all participants through electronic monitoring. In addition, premature infant pain profiles (PIPP) were determined through video recording for all three groups during intervention. The chi-square, ANOVA and ANCOVA were used for analyzing the data, and P < 0.05 was considered significant in this study.ResultsNo significant differences were found between the three groups in mean ± SD of HR, BP, and Sao2 before the intervention (P > 0.05). After the intervention, however, the means for heart rate in groups A, B, and C were 146 ± 14.3, 153 ± 17.5 and 155 ± 17.7, respectively (P = 0.012). Moreover, the means for PIPP scores in groups A, B and C were 6.6 ± 1.3, 10 ± 2, and 11.4 ± 1.9, respectively (P < 0.001). There was no significant difference found between groups in their means of SaO2, systolic and diastolic blood pressure after the intervention (P > 0.05).ConclusionsThe results indicate that stimulation with MBMO is effective in reducing pain in preterm infants; therefore, it can be postulated that this technique can be considered in less invasive procedures such as needling.Trial registrationIRCT, IRCT20190220042771N1. Registered 18 May 2019- Retrospectively registered,

The Calming Effect of Maternal Breast Milk Odor on Term Infant: A Randomized Controlled Trial.

Purpose: This study was carried out to assess the effect of the odor of breast milk and formula milk on reducing the acute pain of newborn infants during the heel-prick blood sampling. Methods: Eighty-four newborn were randomly assigned into two groups (formula milk group and breast milk group) with 42 infant searches. The pain that the newborn felt before, during, and after heel-prick blood sampling was assessed using Neonatal Infant Pain Scale; their heart rate and blood oxygen saturation were measured with a pulse oximeter. Saliva samples were taken from newborns before and after sampling, and their salivary cortisol level was measured. During sampling, the crying duration of newborn was recorded with a chronometer. Results: The pain threshold and heart rates of the newborn in the breast milk group were significantly lower than those in the formula milk group (p < 0.001). Salivary cortisol in the formula milk group increased and oxygen saturation levels in these infants decreased significantly more as compared to the breast milk group (p < 0.05). Conclusions: The odor of breast milk may be helpful in reducing the pain of newborn during heel-prick blood sampling.

A Randomized Controlled Trial: The Effect of Own Mother's Breast Milk Odor and Another Mother's Breast Milk Odor on Pain Level of Newborn Infants.

Objective: Our research was conducted empirically to determine whether another mother's breast milk could be used to reduce the pain of newborns who were not able to access their own mother's milk for any reason. Materials and Methods: The sample group of the research included 90 newborns [smell of own mother's milk (30), smell of another mother's milk (30), and the control group (30)] hospitalized in the unit. A neonatal information form was used as the data collection tool, the Neonatal Pain, Agitation, and Sedation Scale (N-PASS) was used to assess the newborn's pain, and an evaluation form prepared by the researcher was used to record the findings. Results: The group which was exposed to their own mother's milk had a significantly lower N-PASS mean score compared to other groups and the group which was exposed to another mother's milk was observed to have a significantly lower N-PASS mean score compared to the control group (p < 0.05). While the median values for the total time spent crying of the "own mother's milk" group and the "another mother's milk" group were similar; the total time spent crying of the control group had a significantly higher median value. Conclusion: Our research determined that, while the most effective method for reducing pain in newborns was the smell of their own mother's breast milk, for newborns who were not able to access their own mother's breast milk, the smell of breast milk from a different mother could also be used.

The Effect of the Smell of Breast Milk and Non-Nutritious Sucking on Pain Behavioral Response and to First-Time Hepatitis B Vaccine in Term Newborns

Background: The issue of Pain Management finds special significance in infants who are unable to verbally express pain. Studies have shown that the use of non-pharmacological pain control techniques can be effective in reducing neonatal pain. The aim of this study was to compare the effects of olfactory stimulation (with breast milk) and non-nutritive sucking (with a pacifier) on the physiological and behavioral responses in term neonates to the hepatitis B vaccine. Methods: In this clinical trial, which was done in 2015 at the Nohom-e Dey Hospital of Torbat Heidariyeh, 90 eligible infants were randomly selected and divided into two intervention and one control groups. In the breast-milk odor group (n = 30), the neonates were exposed to the mother's odor during vaccination. In the non-nutritive sucking group (n = 30), a standard soft pacifier was used, whereas, in the control group (n = 30), no intervention was carried out. Data collection tools included demographic information forms and the Neonatal Pain Response Scale. Data were edited and analyzed using SPSS 20 software. Results: This study showed that there was a statistically significant difference between the mean scores of neonatal behavioral responses after intervention in the three groups (p &lt;0.05). The mean behavioral response was 0.73 lower in the breast-milk odor group than in the control group, and the mean behavioral response in the non-nutritive sucking group was 0.6 lower than that of the control group. Conclusion: The results of the study showed that both olfactory stimulations with breast milk and non-nutritive sucking have a positive impact on neonatal pain reduction, nearly equally.

Comparing the Effect of Breast Milk Odor and Incubator Cover on Nutritional Adequacy of Premature Infants: A Quasi-Experimental Study

Background: Premature babies face nutritional problems caused by underdevelopment and lack of coordination between sucking, swallowing, and breathing. Appropriate early interventions are needed to promote the nutritional adequacy of these infants. Objectives: This study was designed to compare the effect of breast milk odor and incubator cover on the nutritional adequacy of premature infants. Methods: A quasi-experimental study was conducted on 105 preterm infants aged 28 - 33 weeks who were admitted to the Neonatal Intensive Care Unit (NICU) of Ali Ibn Abi Taleb Hospital in Zahedan in 2018. The subjects were selected via convenience sampling and randomized into three groups: breast milk odor (BMO), incubator cover (IC), and control. Infants in the IC group were placed in an incubator for two hours before feeding. In the BMO group, a gauze soaked with breast milk was placed 1.5 cm away from the infant’s nose in the incubator, and a prescribed amount of milk was given by a syringe to the infant through the mouth. The amount of milk that the baby orally received in the first 10 min (nutritional adequacy) was recorded by a camera, and the results were compared in the three groups. Results: One-way analysis of variance showed a statistically significant difference between the control group and the two groups of incubator cover and breast milk odor (P &lt; 0.001) such that nutritional adequacy was lower in the control group than in the two other groups. Conclusions: Both the smell of breast milk and incubator cover improved the nutritional adequacy of premature infants and enabled them to orally receive more breast milk.

Effects of Combined Use of Mother's Breast Milk, Heartbeat Sounds, and Non-Nutritive Sucking on Preterm Infants' Behavioral Stress During Venipuncture: A Randomized Controlled Trial.

Even routine procedures can cause pain and stress, and can be harmful to the fast-growing brain of preterm infants. Mitigating pain and stress with sucrose and analgesics has side effects; thus, an alternate choice is the use of natural breast milk and infants' sensory capabilities. Therefore, this study examined the effects of different integrations of sensory experiences-mother's breast milk odor and taste (BM-OT), heartbeat sounds (HBs), and non-nutritive sucking (NNS)-on preterm infant's behavioral stress during venipuncture. This study was a prospective, randomized controlled trial. Infants born preterm (<37 weeks' gestational age) were enrolled in the study through convenience sampling, and randomly assigned to the following conditions: (condition 1) routine care (n = 36); (condition 2) BM-OT (n = 33); (condition 3) BM-OT + HBs (n = 33); or (condition 4) BM-OT + HBs + NNS (n = 36). Crying duration from puncture to recovery period was recorded using a voice recorder. Facial actions and body movements were measured using an infant behavioral coding scheme and transformed into frequencies during seven stages: baseline (stage 0), disinfecting (stage 1), venipuncture (stage 2), and the recovery period for 10 minutes (stages 3-6). Data were analyzed for 138 preterm infants. The corresponding median times to stop crying for conditions 1, 2, 3, and 4 were 137, 79, 81, and 39 s, respectively; the instantaneous occurrence rates of stopping crying for conditions 2, 3, and 4 were 1.469, 1.574, and 2.996 times greater than for condition 1, respectively. Infants receiving conditions 3 and 4 had significantly fewer occurrences of facial actions (stage 6 and stages 4-6, respectively) and body movements (stages 3-6 for both); however, there were no significant reductions in stress behaviors for condition 2 (BM-OT). The combination of BM-OT, HBs, and NNS could be provided to preterm infants as interventions to prevent and reduce behavioral stress, and facilitate pain recovery during venipuncture procedures. Clinicians should be educated about how to recognize preterm infants' behavioral stress, and to incorporate different sensory combinations of respective mothers' BM, HBs, and NNS into painful procedures to help preterm infants recover from distress.

The Effects of Different Strategies on the Painful Procedure Management, and the Physiological Parameters in Preterm Infants: A Systematic Review

Background: Since preterm infants are subjected to numerous painful and stressful procedures, various strategies reducing the effects during and after painful procedures are required; we aimed to review the effectiveness of the use of different strategies as a primary or adjunctive treatment on the painful procedures, and the physiological parameters in preterm infants. Materials and Methods: In this systematic review, English databases such as PubMed, Scopus, ISI Web of Science, Cochrane Library and EMBASE were systematically searched without any time limitation up to February 2019. The search keywords were (Aromatherapy OR Olfactory OR Amniotic Fluid OR Milk or odor) AND (Pain OR Venipuncture). Results: Finally, four articles were included. The first study conducted on four groups indicates that the pain profile score and the crying time slightly differed during and after the heel prick procedure. In the second study, having pricked the heel, the breast milk group in comparison with the formula milk group embodied the lower premature infant pain profile (PIPP) score. According to the third study, both the vanilla and the breast milk odors groups indicated soothing effects on the premature infants during sampling; and only the breast milk odor is the soothing factor affecting the infants after the sampling termination. The fourth study found that the infants, who were exposed to their own mother’s milk odor, when compared with the control group, encompassed the lowest median PIPP score during venipuncture. Conclusion: Amniotic fluid, the mother’s milk, vanilla and the mother’s odor were determined as reduction and enhancement factors affecting painful procedures and physiological parameters in preterm infants, respectively.

Aromatherapy as a Nutrition Improvement Approach in Premature Infants: A Short Review

Background: Literature presented numerous methods to promote nutrition in premature newborns. The aim of the review is to promote nutrition in premature newborns using numerous methods which have been suggested by systematic review. Materials and Methods: Online databases including Scopus, Medline, Web of Science, EMBASE, and Cochrane Library were systematically searched to perform the present review. In this search date of publication was not considered and articles from the beginning until February 10, 2019 were included. The keywords of choice were aromatherapy OR smell OR AND OR baby OR preterm OR premature. To evaluate the quality of the studies obtained by searching, Jadad scoring was utilized. Results: Finally, four studies were included for review. In the first study, babies in milk-odor group showed more bursts consisting of more than seven sucking attempts, longer sucking bouts and ingesting more volume of milk in comparison to the control group. According to observations in the second study, elevated number of sucks in the presence of breast milk odor was seen in six of 7 infants switched from tube feeding to full enteral feeds in less time. In the third study, olfactory stimulus shows gestational age-related variations in premature infants babies born prior to 31th week of gestation receiving mother's own milk stimulation were able to feed prior to the control group. In the fourth study, babies born after 31th week of gestation did not show significantly different in response to receiving MOM than control group. Conclusion: Aromatherapy improved feeding behavior by more sucking attempt, longer sucking

Integration of Different Sensory Interventions From Mother's Breast Milk for Preterm Infant Pain During Peripheral Venipuncture Procedures: A Prospective Randomized Controlled Trial.

To compare the effects of integrating mother's breast milk (BM) with three different combinations of sensory stimuli on preterm infant pain during peripheral venipuncture procedures. A prospective, repeated-measures randomized controlled trial. Preterm infants (gestational age between 28 and 37 weeks, and in stable condition) needing venipuncture were recruited by convenience sampling (N = 140) and randomly assigned to four treatment conditions: (a) routine care (condition 1); (b) BM odor or taste (condition 2); (c) BM odor or taste + heartbeat sounds (HBs; condition 3), and (d) BM odor or taste + HBs + non-nutritive sucking (NNS; condition 4). Pain scores were assessed based on the Premature Infant Pain Profile-Revised (PIPP-R) over nine phases: baseline (phase 0, 5 min without stimuli before venipuncture), disinfecting (phase 1), during venipuncture (phase 2), and a 10-min recovery (phases 3-8). Infants who received BM odor or taste + HBs + NNS had significantly lower increases in pain scores from baseline compared with controls across phases 1 through 8. Infants treated with either condition 2 or 3 demonstrated significant reductions in mild pain during disinfecting and recovery phases, as compared with the controls. When condition 2 was used as the reference, there were no significant differences in pain scores between the infants receiving condition 3 across the nine phases, suggesting mothers' HBs have only mild analgesic effects on venipuncture pain. Integration of mother's BM odor or taste, HBs, and tactile NNS should be considered as an intervention for alleviation of procedural pain for preterm infants. Clinicians should incorporate the integrated sensory intervention into caregiving support for preterm infants undergoing short painful procedures.

The Effect of Individualized Developmental Care Practices in Preterm Infants

Background: Preterm infants are vulnerable humans requiring much care and attention. They may be exposed to irregular noise, light, and odor in the neonatal intensive care unit for a period of several weeks or months. This study was carried out to determine the effect of individualized developmental care on physiological parameters, growth, and transition to oral feeding in preterm infants. Methods: The study was a randomized controlled trial. The sample comprised premature infants meeting the inclusion criteria. They were randomly assigned to four groups: the maternal voice group, the breast milk odor (BMO) group, the incubator cover (IC) group, and the control group. Results: No statistically significant difference was found between the groups in terms of weight, height, and head circumference at time of discharge. Mean SO₂ values were statistically higher in the IC group than the other groups; however, the heart rate and respiratory rate were not statistically different in a significant sense between the groups. The briefest duration of transition to total oral feeding was seen in the BMO group. Conclusion: Individualized developmental care practices based on the results of these interventions are likely to support the care of preterm infants. Breast milk odor may ease the transition to breastfeeding.

Is Aromatherapy Effective for Apnea in Preterm Infants? A Systematic Review

Background: Apnea can be associated with many complications such as bradycardia, cyanosis, hypotension, hypotonia, hydrocephalus, neurologic complications, and even death. Pharmacological treatment is associated with many side effects. We aimed to investigate the effect of aromatherapy on Apnea in premature newborns. Materials and Methods: An extensive search was done in databases of Medline, Embase, Scopus, Cochrane, and Web of Science until February 2019. Two independent researchers screened articles, in the next step, full texts of probably relevant articles were summarized and categorized based on the evaluated outcomes and overall effect size was presented. Results: Three studies were included in the systematic review (including 110 preterm infants). Aromatherapy with breast milk odor not with vanilla odor, caused variability of premature infants’ heart rate blood oxygen saturation during and after venipuncture. Calming effects were observed when preterm newborns were exposed to either vanilla or breast milk odors during venipuncture; however, only breast milk odors had a calming effect on subjects after sampling. Breast milk odor was more effective regarding calming effects on premature infants. Infants in olfactory stimulation with anise or cinnamon were discharged from hospital 3.4 days earlier than the control group (p = 0.12). A subgroup analysis of subjects with a body weight of 2,000 grams or more showed a shorter hospitalization period. When compared by gender, better effect was observed in boys than girls with shorter hospitalization in NICU. Conclusion Aromatherapy can be effective for apnea in preterm infants. Due to the small number of participants and low number of articles, the conclusion should be interpreted with caution.