Objective To investigate the analgesic effect (measured with Neonatal Infant Pain Scale (NIPS)) of breastfeeding (BF) in addition to skin-to-skin contact (SSC) versus other methods of non-pharmacological analgesia during blood sampling through heel lance in healthy term neonates.

Design Randomised controlled trial.

Setting Tertiary level maternity ward.

Patients One hundred thirty-six healthy term newborns. Inclusion criteria: healthy term neonates, wish to breastfeed and absence of feeding during the previous 60 min.

Intervention Neonates were randomly assigned to four groups: Group breastfed with SSC (BF+SSC Group) (n=35); Group sucrose with SSC (Sucrose+SSC Group) (n=35); SSC Group (n=33); or Sucrose Group (n=33). Babies were recorded with a video camera.

Outcome measures Three observers watched the videos and measured NIPS score at three time points (t₀: 2 min before heel prick; t₁: During heel prick; and t₂: 2 min after the heel prick). The influences of non-pharmacological methods on crying time, percentage of crying while sampling, heart rate, number of attempts and duration of sampling were also studied.

Results BF+SSC Group achieved a significant lower median NIPS score (value=1) compared with other groups (value=2, 4 and 4, respectively). The percentage of neonates with moderate-to-severe pain was also lower in the BF+SSC Group. Both groups BF+SSC and Sucrose+SSC achieved a significant lower percentage of crying compared with SSC Group.

Conclusions This study suggests that BF in addition to SSC provides superior analgesia to other kinds of non-pharmacological analgesia in healthy term neonates during heel prick.

Trial registration number (ClinicalTrials.gov): NCT01576432