Sweeter than sugar.

Last week a study came out which appears to confirm what some of us probably think is obvious:  breastfeeding provides better pain relief to babies when they get one of those "heel sticks" than a dropper of sugar water.  Here's the study, and here's a press article about it.

This might seem obvious, but there really is a debate at hospitals about what to do for pain relief for newborns during those heel sticks and other procedures.  You might remember that it's just in the last ten years or so that the debate (yes, debate) about whether newborns feel pain at all was resolved.  Some of you may remember your babies being given "Sweet Ease" with a pacifier during a painful procedure.

This study looked at 101 newborns who were getting heel lances to test for congenital disorders.  The study measured babies' heart rate increase, oxygen saturation, and crying behavior after the heel stick.  The breastfed babies were held in their mothers' arms before the procedure, and then stuck with the heel lance once they had started to nurse.  The sugar water babies were given 1 ml of a sucrose solution while lying on an examining table, 2 minutes before the heel stick.

I can hear your protests already.  First, how did they measure crying in the breastfed group when their mouths were full of breasts?  Maybe I missed it, but I couldn't find this addressed in the study.  Second, it's pretty hard to compare the stress levels of babies being held by their mothers with babies who were lying on an examining table.  You know how they love being laid on cold, hard tables!  Third, the nursing babies group was able to suck - a behavior that is in itself calming - while the sugar water babies were not.  Finally, the timing of the stick varied significantly, with the sugar water babies receiving the sugar water significantly before the procedure. 

The authors address some of those concerns, noting "Actually we cannot discriminate the role of the different components of breastfeeding or the mechanisms behind analgesic effect of sucrose solutions: skin-to-skin contact, holding, orotactile stimulation because of oral liquid, or orogustatory stimulation."

So this wasn't the best study.  I mostly write about it because I want you to know that there is an active discussion going on among your healthcare providers about how to help your baby cope during painful procedures.  That in itself is a good thing.  But, and maybe I'm just being cranky about it, the fact that there is any question that breastfeeding, the most basic of newborn calming and nurturing behaviors, provides powerful pain relief is, to me, a little silly.

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