Breastfeeding and Pain Control
by Rallie McAllister, MD, MPH
Proper management of pain is important, even in the neonatal intensive care unit (NICU). When infants suffer pain, it can have serious consequences, both immediately and in the future.
In a recent study*, researchers reported that breastfeeding during minor medical procedures reduced pain in preterm babies who were nursing well.
In infants, pain associated with minor medical procedures, such as pricking a toe for blood tests or starting an IV, is typically managed with skin-to-skin contact, pacifiers, and sweet tastes. Experts say that these pain-management techniques produce only modest or inconsistent pain relief for babies. In healthy, full-term infants, breastfeeding during painful procedures has been shown to reduce the pain response by 80 to 90 percent. Until now, this approach had not been tested in preterm infants. Some experts feared that preterm infants might come to associate breastfeeding with painful procedures, compromising their ability to nurse and gain weight.
The new study was designed to determine whether preterm infants would have lower pain scores when they were allowed to breast feed during blood collection. The researchers also looked at whether breastfeeding during the painful procedure would have a negative impact on the development of the infants’ breastfeeding skills.
The researchers found that among infants whose breastfeeding skills were not fully developed, breasting feeding during painful procedures did not significantly reduce their pain. Still, breastfeeding during painful procedures did not negatively affect breastfeeding skill development in preterm babies.
Among infants who were more advanced in their breastfeeding skills, pain was significantly reduced when they were allowed to breast feed during a painful procedure. Despite concerns that drawing blood samples from breastfeeding infants might be more difficult, the researchers reported that the time taken for the procedure was significantly shorter, making blood collection more efficient.
For infants in pain, breastfeeding might provide some welcome relief.
*Liisa Holsti, Timothy F. Oberlander, and Rollin Brant. Does breastfeeding reduce acute procedural pain in preterm infants in the neonatal intensive care unit? A randomized clinical trial. Pain, 2011 DOI: 10.1016/j.pain.2011.07.022