Development of an Interprofessional Policy on the Use of Human Milk and Breastfeeding for Pain Relief.

Abstract

Background: Infants are subjected to painful procedures as part of routine care. Evidence suggests human milk (HM) has pain-relieving qualities; however, nurses may not be aware of this evidence.

Purpose: This article presents the evidence for HM and breastfeeding for pain management, as well as describes using the evidence to create an interprofessional enterprise-wide policy on the topic.

Methods/search strategy: Cochrane, PubMed, CINAHL, and Medline were searched for full-length articles published in peer-reviewed journals between 2012 and 2020. Articles using HM as an independent variable during a painful procedure, or discussing benefits of HM for pain management, were analyzed.

Findings/results: Ten articles were selected for evaluating use of HM for pain relief in term and preterm infants. There is statistically significant evidence that expressed HM has pain-relieving abilities, especially when combined with other soothing interventions such as rocking. HM reduces crying time, and lowers pain scores during painful procedures. Seven articles recommend breastfeeding for effective pain management. Breastfeeding reduces crying time, heart rate, and pain scores compared with oral sucrose, holding, nonnutritive sucking, swaddling, and topical anesthetics.

Implications for practice: Breastfeeding and HM should be offered as primary pain management options. Having an interprofessional enterprise-wide policy for the use of breastfeeding and HM for pain management during painful procedures, such as vaccination, will provide safe, effective pain management.

Implications for research: Further understanding of effective HM dosing for pain management and use of pasteurized donor HM in place of expressed HM is required.