Hi, Lucy:  If your hospital does not have a policy/procedure/protocol on
neonatal pain relief, it needs to have had one yesterday.  Most hospital
protocols (in the US) for neonatal pain relief include the use of 1-2ml of
Sweet-ease (in lieu of D5) administered orally via syringe to the baby and
the use of a pacifier during the procedure.  There is extensive evidence
and many ongoing/recent studies done on neonatal pain and it has been shown
that giving the baby small amounts of a sweet liquid up to a half hour
before the procedure as well as a pacifier to suck on during the procedure
is very effective in helping the baby deal with any pain issues.  Studies
have shown that endorphins (body's natural pain reliever) are released into
the baby's system when these two things are done.  Of course we all know
that the breast accomplishes the same thing!  Sweet milk and opportunity to
suck!  There have also been some recent studies showing that baby's pain
reaction is minimal at most if baby is sucking at breast during routine
immunizations.  Some of the younger women lab techs at our hospital have
become more comfortable doing heelsticks on babies that are at the breast
and express amazement at how calm these babies are during the procedure as
opposed to those not at the breast.
I would suggest your hospital immediately look into developing a policy
such as the one I have described.  This should help prevent the situation
that you describe with this particular mother.  Also parents are educated
on the protocol beforehand and even the most die-hard breastfeeders usually
are accepting of the protocol.  For a mom who might not want Sweet-ease
being given to her baby, I don't see the problem with her supplying a feww
mls of EBM to be given to the baby as he is being readied for his circ.
Sorry for the length, but hope this is helpful to you.

Pam Hirsch, RN,BSN,CLC
Clinical Lead, Lactation Services
Advocate Good Shepherd Hospital
Barrington, IL   USA

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