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. 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