Tuesday, August 30, 2016
Analgesic effect of expressed breast milk during screening for retinopathy of prematurity screening in neonates: A randomised controlled trial
Retinopathy of prematurity (ROP) is a cause of blindness in neonates. Given the preventable nature of the condition, it is essential to screen neonates for ROP. However, the screening procedure is painful and requires repeated examinations. Breast milk has been found to be an effective analgesic for several other painful procedures. A randomised controlled trial published in the Journal of Tropical Paediatrics evaluated the efficacy of expressed breast milk (EBM) in reducing pain experienced during ROP screening.
Rosali et al. conducted a trial in which 40 neonates (gestational age <35 weeks) who were on oral feeds were randomised to intervention (EBM + Standard practice) and control groups (standard practice). Each group comprised 20 neonates. The standard practice comprised nesting and swaddling the neonates and administration of proparacaine. In the intervention group, neonates were given 2 mL of EBM orally 2 minutes before the procedure along with standard practice. Pain was assessed by the Premature Infant Pain Profile (PIPP) score, during and at 1 minute and 5 minutes after the procedure.
Neonates in the intervention group had significantly lower PIPP scores compared to those in the control group during the procedure. This effect persisted at 1 minute and 5 minutes after the procedure. There were no adverse effects of vomiting or apnea among neonates who received EBM.
The PIPP scale is a very objective, reliable and validated tool for the assessment of pain response in preterm neonates. Based on the findings of the study, it was concluded that EBM helps in the reduction of severe pain experienced during ROP screening and this analgesic effect lasts for 5 minutes after the completion of the procedure in neonates.
News source - Rosali L, Nesargi S, Mathew S, et al. Efficacy of Expressed Breast Milk in Reducing Pain During ROP Screening—a Randomized Controlled Trial. Journal of Tropical Paediatrics. 2015 Apr;61(2);135-138.