A Randomized Control Trial to Test Multi-Sensory Breast Milk on Neonatal Pain During Heel-Stick Procedures

Friday, 26 July 2019

Jen-Jiuan Liaw, PhD, RN
School of Nursing, National Defense Medical Center, Taipei, Taiwan
Luke Yang, PhD
Department of Social Welfare, Hsuan Chuang University, Hsinchu, Taiwan
Chiao Hsuan Lin, RN
Department of Nursing, Tri-Service General Hospital, Taiwan., Taipei City, Taiwan

Purpose: Newborns undergo many necessary invasive procedures for routine care that may cause stress and pain. Newborns are unable to verbally express their pain and stress, but they can perceive pain that can influence their physical and neurodevelopment in the future. Caregivers often neglect and do not pharmacologically treat the newborns’ pain. Therefore, clinicians and researchers attend the pain problem and develop some nonpharmacological interventions to reduce neonatal pain and stress. Therefore, the study purposes were to test the effects of breast milk as multiple sensory interventions on newborns’ pain responses, physiological index (heart rate and oxygen saturation), and crying event during heel stick procedures.

Methods: A prospective, randomized controlled trial. A newborn nursery of a medical center in northern Taiwan. Healthy Infants with gestational age≧38 weeks were recruited by convenience sampling from October in 2017 to October in 2018. One-hundred and twenty term newborns who met the criteria were recruited and were randomly assigned to three treatment groups: (1) gentle touch + talk, (2) smell + gentle touch + talk, (3) smell + taste + gentle touch + talk. Pain response was measured by using the Neonatal Infant Pain Scale (NIPS). The physical index (heart rate, oxygen saturation) and duration of crying were measured by using Masimo Rad 5 Pulse Oximetry monitors. All data were collected 5 minutes before heel-stick (baseline), during heel-stick and 5 minutes after the procedures (recovery status).

Results: The study results suggest that infants receiving ‘smell + Taste + gentle touch + talk’ showed lower pain scores when they underwent heel-stick procedures than those infants of the control group. The outcomes showed that the NIPS scores (p<0.001), average heart rate, average oxygen saturation, and duration of the crying events (p<0.001) were all significantly better than those receiving ‘gentle touch + talk’ after adjusting the baseline data, time, and neonatal characteristics.

Conclusion: The breast milk multi-sensory interventions can be used to reduce neonatal pain and stress and crying duration during the heel-stick procedures. Also the use of smell and taste of breast milk can help stablize the newborns’ heart rates and oxygen saturation during the invasive procedures. Nurses can provide the smell and taste of breast milk to the newborns and try comfort their stress and relieve pain through stimulating the newborns’ sensory abilities. Also, the use of the newborns’ sensory abilities and proper pain-relief will improve the newborn’s health and development.