A randomized study was done to compare non pharmacological methods to reduce the
pain of heel pricks in 104 stable term neonates. Non-nutritive sucking (NNS), rocking,
massage,
sucrose (20 percent), distilled water (DW) and expressed breast milk (EBM) were used as
pain reducing agents. Duration of cry and Douleur Aiguë du Nouveau né (DAN) score were used to assess
pain. Physiological parameters were also recorded before and after the stimulus. At 30 seconds after the stimulus, the
pain scores were lowest in the
sucrose group but this was not sustained at 1, 2 and 4 minutes. At 2 and 4 minutes
pain scores were lowest in the NNS and rocking groups as compared to
sucrose, distilled water, expressed breast milk and
massage. The total duration of crying was also lowest in the NNS and rocking groups. Physiological parameters were comparable in all groups. Babies who were in Prechtl State 1 and 2 (sleeping) at the time of stimulus showed significantly lesser response to
pain compared to babies who were awake. This was seen in all the intervention groups. In conclusion, our study suggests that rocking or giving a baby a
pacifier are more effective non-pharmacological
analgesics than EBM, DW,
sucrose or
massage for the
pain of heel pricks in neonates. A calm or sleeping state before a painful procedure also appears to decrease crying and
pain scores.