Heel lance in newborn during breastfeeding: an evaluation of analgesic effect of this procedure

We studied 200 healthy full term newborns (100 cases and 100 controls), proposing the puncture to mothers during breastfeeding, and explaining to them all the advantages of this practice. Pain assessment was evaluated by DAN scale (Douleur Aigue Nouveau ne scale).The difference in score of pain according to the DAN scale was significant in the two groups of patients (p = 0.000); the medium score was 5.15 for controls and 2.65 for cases (newborns sampled during breastfeeding).Our results confirmed the evidence of analgesic effect of breastfeeding during heel puncture. This procedure could easily be adopted routinely in maternity wards.Scientific studies show that even very premature newborns may experience sensation of distress which could unfavourably influence many clinical and behavioural parameters of their present and future [1]. Pain control in newborns is so primary importance, also stressed by the American Academy of Paediatrics [2]. The purpose of our study was comparing the analgesic effects of sucking own mother milk, versus alternative chances like caressing and/or pacifier, during routine invasive procedures in full-term newborns. The most painful routine invasive procedures in full-term newborns include venous blood sample and capillary heel stick blood sampling [3]. The analgesic effect of oral glucose 24% solution [4], pacifiers [5] and skin-to-skin contact [6] have already been demonstrated. The use of sucrose and/or pacifier for analgesia may interfere with a correct beginning of breastfeeding [7], so it may be an interesting alternative to test the analgesic effect of breastfeeding during painful procedures. In a recent review by Shah PS et al [8] breastfeeding is associated with changes in heart rate, duration of cry, percentage of crying time and a decrease of measured pain. Breastfeeding instead, does not seem to be favourable, if compared with higher glucose concentrations, with regards for crying duration, PIPP score and DAN score [9-11]. This