A Cochrane review [Abstract] 1 included 10 studies with a total of 1066 infants. Breastfeeding reduced behavioural pain responses (cry time and pain scores) during vaccination compared to no treatment, oral water, and other interventions such as cuddling, oral glucose, topical anaesthetic, massage, and vapocoolant. Breastfeeding did not consistently reduce changes in physiological indicators, such as heart rate. Breastfeeding compared to water or no treatment resulted in a 38-second reduction in cry time (MD -38, 95% CI -50 to -26; P < 0.00001; 6 trials, n=547). Breastfeeding was associated with a 1.7-point reduction in standardised pain scores (SMD -1.7, 95% CI -2.2 to -1.3; 5 trials, n=310). Breastfeeding was more effective in reducing crying duration or pain scores during vaccination compared to: 25% dextrose and topical anaesthetic cream (EMLA), vapocoolant, maternal cuddling, and massage.
Another Cochrane review [Abstract] 2assessing the efficacy of non-pharmacological interventions for infant and child (up to 3 years) acute pain, excluding kangaroo care and music, included 63 studies with a total of 4 905 subjects. The most commonly studied acute procedures were heel-sticks (32 studies) and needles (17 studies). The largest SMD for treatment improvement over control conditions on pain reactivity were: non-nutritive sucking-related interventions (neonate SMD -1.20, 95% CI -2.01 to -0.38), and swaddling/facilitated tucking (preterm SMD -0.89, 95% CI -1.37 to -0.40). For immediate pain-related regulation, the largest SMDs were: non-nutritive sucking-related interventions (preterm SMD -0.43, 95% CI -0.63 to -0.23; neonate SMD -0.90, 95% CI -1.54 to -0.25; older infant: SMD -1.34, 95% CI -2.14 to -0.54), swaddling/facilitated tucking (preterm SMD -0.71, 95% CI -1.00 to -0.43), and rocking/holding (neonate SMD -0.75, 95% CI -1.20 to -0.30). Fifty two of the 63 trials did not report adverse events.
Date of latest search: 18 February 2016
Primary/Secondary Keywords