Efficacy of expressed breast milk in reducing pain during ROP screening--a randomized controlled trial

Area of Science:

• Neonatal care
• Ophthalmology
• Pain management

Background:

• Retinopathy of prematurity (ROP) screening is a common procedure for premature infants.
• Pain experienced during ROP screening can have negative short-term and long-term effects on neonates.
• Non-pharmacological interventions are sought to minimize procedural pain in vulnerable infants.

Purpose of the Study:

• To evaluate the efficacy of expressed breast milk (EBM) as a pain-reducing agent during ROP screening.
• To compare pain scores in neonates receiving EBM versus standard care.
• To determine if EBM provides sustained pain relief post-procedure.

Main Methods:

• A randomized controlled trial was conducted involving neonates on oral feeds undergoing ROP screening.
• Participants were assigned to either an intervention group (EBM + standard practice) or a control group (standard practice only).
• Standard practice included proparacaine eye drops, nesting, and swaddling. Pain was assessed using the Premature Infant Pain Profile (PIPP) scale by a blinded investigator.

Main Results:

• Both groups had similar baseline characteristics.
• The EBM group exhibited significantly lower PIPP scores during the ROP screening compared to the control group (12.7 ± 1.69 vs. 15.5 ± 1.78, p < 0.05).
• This pain reduction was sustained at 1 and 5 minutes post-procedure (1 min: 6.20 ± 1.9 vs. 12.4 ± 2.54, p ≤ 0.05; 5 min: 3.2 ± 1.5 vs. 6.85 ± 2.4, p < 0.05).

Conclusions:

• Oral administration of expressed breast milk is an effective method for reducing neonatal pain during ROP screening.
• EBM provides significant and lasting pain relief following the procedure.
• This finding supports the use of EBM as a safe and accessible non-pharmacological intervention for procedural pain in neonates.