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Analgesia with breastfeeding in addition to skin-to-skin contact during heel prick
  1. Miguel Ángel Marín Gabriel1,
  2. Beatriz del Rey Hurtado de Mendoza1,
  3. Lourdes Jiménez Figueroa2,
  4. Virginia Medina2,
  5. Beatriz Iglesias Fernández1,
  6. María Vázquez Rodríguez2,
  7. Virginia Escudero Huedo2,
  8. Lorena Medina Malagón2
  1. 1Deparment of Pediatrics, Hospital Puerta de Hierro-Majadahonda, Madrid, Spain
  2. 2Department of Obstetrics and Ginecology, Hospital Puerta de Hierro-Majadahonda, Madrid, Spain
  1. Correspondence to Dr Miguel Ángel Marín Gabriel, Hospital Universitario Puerta de Hierro-Majadahonda, C/Manuel de Falla s/n. CP 28222, Majadahonda, Madrid, Spain; mangel.maringa{at}


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 ( NCT01576432

  • Neonatology
  • Pain

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