COMPARATIVE ANALGESIC EFFICACY OF EXPRESSED BREAST MILK VERSUS ORAL 25% DEXTROSE DURING VENIPUNCTURE IN CLINICALLY STABLE PRETERM NEONATES ON ORAL FEEDS: A RANDOMIZED COMPARATIVE STUDY
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Keywords
Premature infants; Procedural pain; Expressed breast milk; Dextrose 25%; Neonatal analgesia; PIPP score; Non-pharmacological pain relief
Abstract
Background: Neonates undergo multiple painful procedures in early life, and adequate pain relief is crucial due to the long-term neurodevelopmental consequences of unrelieved pain. Among the various non-pharmacological strategies, expressed breast milk (EBM) and oral dextrose have shown promise. This study aimed to compare the analgesic efficacy of EBM versus oral 25% dextrose in clinically stable preterm neonates undergoing venipuncture.
Methods: A hospital-based randomized controlled study was conducted in the postnatal ward of a tertiary care centre in New Delhi from January to June 2020. A total of 110 preterm neonates (gestational age 30–36+6 weeks, birth weight 1500–2500 g) were randomized to receive either 2 mL of EBM (n=55) or 2 mL of oral 25% dextrose (n=55) one minute before venipuncture. Pain was assessed using the Premature Infant Pain Profile (PIPP) at four intervals up to 5.5 minutes after the procedure. Secondary outcomes included crying time, heart rate, and oxygen saturation.
Results: Baseline characteristics were comparable between the two groups. Mean crying time was significantly lower in the 25% dextrose group (69.09 ± 16.59 s) compared to the EBM group (86.91 ± 18.84 s; p<0.001). Post-procedural heart rate was lower and oxygen saturation higher in the dextrose group. Mean PIPP scores were significantly lower in the dextrose group at all time points (p<0.001), confirming superior analgesic effect.
Conclusion: Oral 25% dextrose is more effective than expressed breast milk in alleviating venipuncture pain in preterm neonates. Its low cost, availability, and ease of use make it a practical choice in routine neonatal care.
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Santosh Kr Pandey
Senior Resident, Pediatrics; ESIC Medical College and Hospital, Pandeypur, Varanasi
Neeraj Nagar
Specialist, Pediatrics; ESIC Medical College and Hospital, Noida.
Rekha
Senior Specialist, Pediatrics; Deen Dayal Upadhyay Hospital, Hari Nagar, Delhi.