This is the part of the Medscape summary that concerned me the most:

"Neonatal pain prevention is the expectation of the parents and should be
the goal of the medical staff; therefore, family members or staff may be
recruited to help during these procedures, and nursing mothers should be
encouraged to breastfeed during the procedure," the study authors conclude.
*"If family members believe that they cannot withstand the procedure, hear
their infant crying, or see the heel-lancing, then bottle-feeding seems to
be a good alternative."  *(underlined by me for emphasis)

It is very disheartening to see breastfeeding and bottle-feeding STILL
considered so interchangeable by health researchers!

Barb Berges BS, RN, IBCLC
near Cleveland, Ohio



>
> Date:    Sat, 14 Nov 2009 16:21:22 -0800
> From:    Jeanette Panchula <[log in to unmask]>
> Subject: Newborn Pain Control Methods
>
> I just read the summary in Medscape
> <http://cme.medscape.com/viewarticle/712142?src=cmenews&uac=26875CK> of
> the
> article that is summarized in the abstract below.  Note that the responses
> to pain by the infants being BREASTFED was lower than that of the infants
> that were being fed "oral formula" - however, THAT information is not
> highlighted in the reports.
>
> Heel-Lancing in Newborns: Behavioral and Spectral Analysis Assessment of
> Pain Control Methods PEDIATRICS Vol. 124 No. 5 November 2009, pp. e921-e926
> (doi:10.1542/peds.2009-0598) Amir Weissman, MDa, Michal Aranovitch, RN,
> MScb,c, Shraga Blazer, MDb,d and Etan Z. Zimmer, MDa,b
>
> a Departments of Obstetrics and Gynecology
> d Neonatology, Rambam Health Care Campus
> b Rappaport Faculty of Medicine, Technion-Israel Institute of Technology,
> Haifa, Israel
> c Department of Neonatology, Lady Davis Carmel Medical Center, Haifa,
> Israel
>
> OBJECTIVE: Pain experience can alter clinical outcome, brain development,
> and subsequent behavior in newborns, primarily in preterm infants. The aims
> of this study were (1) to evaluate several simple, commonly used methods
> for
> pain control in newborns and (2) to evaluate the concordance between
> behavioral and autonomic cardiac reactivity to pain in term neonates during
> heel-lancing.
>
> METHODS: A prospective study was conducted of 180 term newborn infants who
> were undergoing heel-lancing for routine neonatal screening of
> phenylketonuria and hypothyroidism. Newborns were assigned to 6 groups: (1)
> control (no pain relief intervention); (2) nonnutritive sucking; (3)
> holding
> by mother; (4) oral glucose solution; (5) oral formula feeding; or (6)
> breastfeeding. Outcome measures included the Neonatal Facial Coding System
> score; cry duration; and autonomic variables obtained from spectral
> analysis
> of heart rate variability before, during, and after heel-lancing.
>
> RESULTS: Infants with no pain control showed the highest pain manifestation
> compared with newborns to whom pain control was provided. Infants who
> breastfed or received an oral formula showed the lowest increase in heart
> rate (21 and 23 beats per minute, respectively, vs 36; P < .01), lowest
> neonatal facial score (2.3 and 2.9, respectively, vs 7.1; P < .001), lowest
> cry duration (5 and 13 seconds, respectively, vs 49; P < .001), and lowest
> decrease in parasympathetic tone (-2 and -2.4, respectively, vs 1.2; P <
> .02) compared with the other groups.
>
> CONCLUSIONS: Any method of pain control is better than none. Feeding and
> breastfeeding during heel-lancing were found to be the most effective
> methods of pain relief.
>
> CONCLUSION - we don't want to make moms feel "guilty" so we have to make it
> sound as if breastfeeding and "oral formula" is equivalent!
>
> (I know, the rationale will be that there were only 30 formula-fed infants
> and 31 breastfed infants, so they did not achieve statistical significance!
> WHY - because they never bothered to design it so that it COULD!)
>
> Jeanette Panchula, BSW, RN, PHN, IBCLC
>
> California, USA
>
>
>
>
>             ***********************************************
>
> Archives: http://community.lsoft.com/archives/LACTNET.html
> To reach list owners: [log in to unmask]
> Mail all list management commands to: [log in to unmask]
> COMMANDS:
> 1. To temporarily stop your subscription write in the body of an email: set
> lactnet nomail
> 2. To start it again: set lactnet mail
> 3. To unsubscribe: unsubscribe lactnet
> 4. To get a comprehensive list of rules and directions: get lactnet welcome
>
> ------------------------------
>
> End of LACTNET Digest - 13 Nov 2009 to 14 Nov 2009 - Special issue
> (#2009-1054)
>
> *******************************************************************************
>

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome