Hindmilk for procedural pain in term neonates

Area of Science:

• Neonatal care
• Pain management
• Lactation studies

Background:

• Heel stick procedures are common in neonates, causing significant pain.
• Current pain relief methods include oral sucrose, but alternatives are sought.

Purpose of the Study:

• To evaluate the efficacy of repeated hindmilk doses for pain relief in term neonates during heel stick.
• To compare hindmilk's analgesic effect with 12.5% sucrose and placebo (distilled water).

Main Methods:

• Double-blind, placebo-controlled study involving term neonates.
• Random assignment to hindmilk, 12.5% sucrose, or distilled water groups.
• Administration of 1 ml test solution at 1 minute pre-heel stick, immediately before, and 1 minute after.
• Pain assessment using physiologic, behavioral parameters, and Neonatal Facial Coding System (NFCS).

Main Results:

• Hindmilk significantly reduced crying time, cry duration, tachycardia, and time to return to baseline heart rate compared to distilled water.
• Hindmilk also lowered average, 1-minute, and 5-minute NFCS scores versus distilled water.
• 12.5% sucrose showed a statistically superior analgesic effect over hindmilk only at 1- and 2-minute NFCS assessments.

Conclusions:

• Repeated hindmilk administration is an effective analgesic for heel stick pain in term newborns.
• Hindmilk presents a physiologically suitable alternative to sucrose for neonatal pain relief.