Breastfeeding or Oral Sucrose Solution Free Essay Example, 500 words

ï » ¿ Breastfeeding or Oral Sucrose Solution Introduction The pain is the presence of mild, annoying or extremely severe feeling triggered in the nervous system. The individual may experience pain in a particular region of the body or he may suffer from whole body ache. The unpleasant feeling of pain implies that our body requires attention and may indicate medical problem that needs treatment. This sensation is very important to take care of our body and for our well being. Thus, pain is a crucial component of our body’s defense mechanism and prevents further damage to the body. Pain causes both physical and psychological disturbances. Pain perceived by each individual is different, therefore can be referred as subjective sensation. Pain sensation plays an important role in early warning to safeguard interests of our body as well as assist in repair mechanisms. Neonates are not able to express their pain effectively since they are not able to talk. Therefore, it becomes difficult to assess and manage the pain in neonates. The safet y and efficacy of pain management techniques is always worrisome issue for the health care professionals who care for neonates and parents of newborns (preterm to 1 month of age). We will write a custom essay sample on Breastfeeding or Oral Sucrose Solution or any topic specifically for you Only $17.96 $11.86/pageorder now For the pain assessment in interm and preterm neonates, the diverse ranges of validated and trustworthy pain measures are available. The behavioral pain symptoms include facial expression, body movements, crying etc. and physiological signs of pain include changes in heart rate, respiratory rate, blood pressure, oxygen saturation etc. The composite measures include the Premature Infant Pain Profile (PIPP), CRIES, and Neonatal Infant Pain Scale (NIPS). The PIPP includes facial expressions and physiological indicators. In CRIES assessment technique, Crying, the Requirement for oxygen supplementation (for SaO2 >95%), Increase in heart rate and blood pressure, facial Expression and Sleeplessness is monitored. In NIPS scale, the movements of arms and legs, and state of arousal are also additionally monitored in neonates (American Academy Of Pediatrics, 2000). Brief summaries There are multimodal approaches available which might help to relieve pain to produce adequate, reliable and satisfactory therapy in neonates. Breastfeeding or oral sucrose solution in term neonates receiving heel lances Heel lance is a painful diagnostic test for neonatal screening using automated piercing device to detect specific congenital disorders. The analgesic effect of breastfeeding and orally administered sucrose solution (1 ml of 25% sucrose solution) was studied during blood sampling through heel lance in open-label, randomized, controlled trial at a neonatal unit. Median Premature Infant Pain Profile scores were lower in the breastfeeding group (3.0) than in the sucrose-solution group (8.5), and the median group difference was –5.0. The median heart rate increase, oxygen saturation decrease, and duration of first cry for the breastfeeding group were, respectively, 13.0, –1, and 3 and for sucrose group were 22, –3, and 21. Medians were significantly different between the groups. There were no significant differences in the sampling duration and numbers of heel lances. It has been reported that during acute pain rating scale of the Premature Infant Pain Profile, the b reastfeeding group scores are less (3.0) than in the sucrose-solution group (8.5), with median group difference was –5.0. The increase in median heart rate, decrease oxygen saturation and duration of first cry for breastfeeding neonates 13.0, –1, and 3 and for sucrose therapy individuals were 22, –3, and 21 respectively. It has been concluded that for pain resulting from heel lance, the breastfeeding has great pain reduction power than oral sucrose therapy in term neonates (Codipietro, Ceccarelli, & Ponzone, 2008). Skin to skin contact is analgesic in healthy newborns The effect of skin-to-skin contact between mothers and their healthy newborns in terms of pain reduction during heel lance is evaluated. It has been found that crying and grimacing were reduced by 82% and 65%, respectively in skin contact intervention technique than control infants (swaddled in crib). Also, decrease in the heart rate was observed in skin contact intervention technique. Therefore, it has been concluded that skin to skin contact intervention technique has analgesic in healthy newborns (Gray, Watt, & Blass, 2000). The role of endogenous opioids in mediating pain reduction by orally administered glucose among newborns It has been suggested that the administration of sweet-tasting solutions like glucose before any painful procedure alleviates pain in newborns due to activation of endogenous opioids. To evaluate this mechanism the effect of intravenous administration of opioid antagonist (naloxone hydrochloride 0.01 mg/kg) was studied in randomized, placebo-controlled, and double-blind trials undergoing heel stick. In control group saline solution was administered as placebo. Pain scores on Premature Infant Pain Profile and heart rate were same. The median crying time during the first 3 minutes was 14 seconds (range: 0–174 seconds) for the naloxone group and 105 seconds (range: 0–175 seconds) for the placebo group. It was concluded that opioid antagonist is not responsible for decrease in analgesic activity of glucose solution in newborns (Gradin & Schollin, 2005). Pain reduction at venipuncture in newborns: oral glucose compared with local anesthetic cream It has been suggested that the local anesthetic application of EMLA cream is safe and effective in neonates. The analgesic effect of EMLA cream and orally administered sucrose solution (1 ml of 25% sucrose solution) was studied during venipuncture in newborns in randomized, controlled double-blind trial at a neonatal unit. It was investigated that premature Infant Pain Profile scores were less in the glucose group 19.3% (mean: 4.6) compared with the EMLA group 41.7% (mean: 5.7). The median crying time during the first 3 minutes was 1 second than in the EMLA group where observed median was 18 seconds. Therefore, it was concluded that the pain associated with venipuncture in newborns is considerably reduced with orally administered glucose than the local anesthetic cream EMLA. Conclusion There is always a great concern about the safety and efficacy of pain management techniques in neonates. There are multimodal approaches available which might help to relieve pain to produce adequate, reliable and satisfactory therapy in neonates. The pain resulting from heel lance, the breastfeeding has great pain reduction power than oral sucrose therapy in term neonates. The skin to skin Contact intervention technique has analgesic in Healthy newborns. The opioid antagonist is not responsible for decrease in analgesic activity of glucose solution in newborns. The pain associated with venipuncture in newborns is considerably reduced with orally administered glucose than the local anesthetic cream EMLA. References American Academy Of Pediatrics (2000). Prevention And Management Of Pain And Stress In The Neonate. Pediatrics, 105(2), 454 – 461. Codipietro, L., Ceccarelli, M., Ponzone, A. (2008). Breastfeeding or Oral Sucrose Solution in Term Neonates Receiving Heel Lance: A Randomized, Controlled Trial. Pediatrics, 122, e716-e721 Gray, L., Watt, L., Blass, E. M. (2000). Skin-to-skin contact is analgesic in healthy newborns. Pediatrics, 105 (1), e14 Gradin, M. and Schollin, J. (2005). The Role of Endogenous Opioids in Mediating Pain Reduction by Orally Administered Glucose Among Newborns. Pediatrics, 115(4), 1004 – 1007. Gradin, M., Eriksson, M., Holmqvist, G., Holstein, A., Schollin, J. Pain reduction at venipuncture in newborns: oral glucose compared with local anesthetic cream. Pediatrics, 110(6), 1053 – 1057.