Breastfeeding during immunizations or other painful procedures

compiled by Kelly Bonyata, IBCLC

Breastfeeding during a painful procedure such as a heel-stick for newborn screening provides analgesia to infants.

– American Academy of Pediatrics policy statement on breastfeeding

Research indicates that breastfeeding your baby during a minor painful procedure (immunization, blood draw, etc.) is a safe and effective method of pain relief.

References (most recent listed first)

Breastfeeding as pain relief

Okan F, Ozdil A, Bulbul A, Yapici Z, Nuhoglu A. Analgesic effects of skin-to-skin contact and breastfeeding in procedural pain in healthy term neonates. Ann Trop Paediatr. 2010;30(2):119-28.

Shah PS, Aliwalas L, Shah V. Breastfeeding or breastmilk to alleviate procedural pain in neonates: a systematic review.. Breastfeed Med. 2007 Jun;2(2):74-82.

Section on Breastfeeding. Breastfeeding and the Use of Human Milk. Pediatrics 2005 (Feb 1);115(2):496-506. “Breastfeeding during a painful procedure such as a heel-stick for newborn screening provides analgesia to infants.

Shendurnikar N, Gandhi K. Analgesic effects of breastfeeding on heel lancing. Indian Pediatr. 2005;42(7):730-2.

Zempsky WT, Cravero JP; American Academy of Pediatrics Committee on Pediatric Emergency Medicine and Section on Anesthesiology and Pain Medicine. Relief of pain and anxiety in pediatric patients in emergency medical systems. Pediatrics. 2004 Nov;114(5):1348-56. “Skin-to-skin contact of an infant with his or her mother and breastfeeding during a procedure decrease pain behaviors associated with painful stimuli.”

Upadhyay A, Aggarwal R, Narayan S, Joshi M, Paul VK, Deorari AK. Analgesic effect of expressed breast milk in procedural pain in term neonates: a randomized, placebo-controlled, double-blind trial. Acta Paediatr. 2004 Apr;93(4):518-22.

Gradin M, Finnstrom O, Schollin J. Feeding and oral glucose–additive effects on pain reduction in newborns. Early Hum Dev. 2004 Apr;77(1-2):57-65. (Note that infants were only breastfed before–not during–the blood draws in this study.)

Potter B, Rindfleisch K. Breastfeeding reduces pain in neonates. J Fam Pract. 2003 May;52(5):349, 352.

Carbajal R, Veerapen S, Couderc S, Jugie M, Ville Y. Analgesic effect of breast feeding in term neonates: randomised controlled trial. BMJ 2003 ( 4 January );326:13.

Gray L, Miller LW, Philipp BL, Blass EM. Breastfeeding is analgesic in healthy newborns. Pediatrics 2002;109(4):590-593.

Other interventions as pain relief

Other effective interventions include skin to skin contact, sugar water and/or sucking on a pacifier, and multisensory stimulation.

Kandasamy Y, Smith R, Wright IM, Hartley L. Pain relief for premature infants during ophthalmology assessment. J AAPOS. 2011;15(3):276-80.

Elserafy FA, Alsaedi SA, Louwrens J, Bin sadiq B, Mersal AY. Oral sucrose and a pacifier for pain relief during simple procedures in preterm infants: a randomized controlled trial. Ann Saudi Med. 2009;29(3):184-8.

Carbajal R, Lenclen R, Gajdos V, Jugie M, Paupe A. Crossover trial of analgesic efficacy of glucose and pacifier in very preterm neonates during subcutaneous injections. Pediatrics. 2002 Aug;110(2 Pt 1):389-93.

Bellieni CV, Bagnoli F, Perrone S, Nenci A, Cordelli DM, Fusi M, et al. Effect of multisensory stimulation on analgesia in term neonates: a randomized controlled trial. Pediatr Res 2002; 51: 460-463.

Johnston CC, et al. Routine sucrose analgesia during the first week of life in neonates younger than 31 weeks’ postconceptional age. Pediatrics. 2002 Sep;110(3):523-8.

Anand KJS, the International Evidence-Based Group for Neonatal Pain. Consensus statement for the prevention and management of pain in the newborn. Arch Pediatr Adolesc Med 2001; 155: 173-180.

Stevens B, Taddio A, Ohlsson A, Einarson T. Sucrose for analgesia in newborn infants undergoing painful procedures. Cochrane Database Syst Rev 2001;(4):CD001069.

Gray L, Watt L, Blass EM. Skin-to-skin contact is analgesic in healthy newborns. Pediatrics 2000; 105(1): E14.

Carbajal R, Chauvet X, Couderc S, Olivier-Martin M. Randomised trial of analgesic effects of sucrose, glucose, and pacifiers in term neonates. BMJ 1999; 319: 1393-1397.

Blass EM, Watt LB. Suckling- and sucrose-induced analgesia in human newborns. Pain 1999; 83: 611-623.