Neonatal Analgesia: The Effect of Mother’s Milk Odour on the Perception of Procedural Pain in Preterm Neonates

Vohra, Arif S.; Vaishnav, Jolly G; Patel, Darshan Pankajbhai; Mehta, Parishi; H, Anshad

doi:10.22038/jpp.2025.71071.5244

Neonatal Analgesia: The Effect of Mother’s Milk Odour on the Perception of Procedural Pain in Preterm Neonates

Document Type : original article

Authors

Arif S. Vohra ¹

Jolly G Vaishnav ²

Darshan Pankajbhai Patel ³

Parishi Mehta ³

Anshad H ³

¹ Assistant Professor, Department of Pediatrics, BJ Medical College, Civil Hospital, Ahmedabad, India.

² Professor and Head of Unit, Department of Pediatrics, BJ Medical College, Civil Hospital, Ahmedabad, India.

³ Resident, Department of Pediatrics, BJ Medical College, Civil Hospital, Ahmedabad, India.

10.22038/jpp.2025.71071.5244

Abstract

Background and Aims: Neonatal pain in preterm neonates can adversely affect their development in multiple domains as nociceptive changes, altered brain development, stress system and functional abilities. We have plan research to determine whether odour of mother milk is effective to reduce the pain of preterm neonates who are not able to access their own mother’s milk for any reason.
Material and Method: A prospective randomized control trial was done at postnatal ward, Civil Hospital, Ahmedabad in 100 vaginally delivered Preterm neonates (34-36 weeks) without any antenatal, intra-nata and postnatal complications; they were divided into two groups. Group A (EBM group) was given odour of own mother’s milk and Group B (sterile water group) was given odour of sterile water as an analgesic agent.
Results : There was a significant decrease in PIPP score in Group A (EBM group) (8.72±1.21) as compare to Group B (sterile water group) (14.12±0.86) with a p-value <0.0365. There was significant decrease in maximum heart rate observed in Group A (EBM group) (132.22±13.28) compared to Group B (sterile water group) (136.54±25.12) during 30 sec from removal of needle (p-value -0.0448). There was a significant decrease in the fall in oxygen saturation in Group A (EBM group) (96.74±4.72) compared to Group B (sterile water group) (94.48±7.44) with a p-value of -0.00457.
Conclusion: Inhalation of own mother’s milk for is effective analgesic for mild to moderate pain in preterm neonates. Inhalation of own mother milk before procedure or during procedure can be use as non-pharmacology intervention to reduce pain in preterm neonates in whom breastfeeding is contraindicated due to any reason

Keywords

Neonatal Pain

Neonatal Analgesia

Preterm

PIPP score

Bilgen H, Özek E, Cebeci D, Örs R. Comparison of sucrose, expressed breast milk, and breast-feeding on the neonatal
response to heel prick. The Journal of Pain. 2001 Oct 1;2(5):301-5. Effect of Mother’s Milk Odour on Perception of Procedural Pain J Ped Perspect, Vol.12, N.12, Serial No.132, Dec. 2024 19203.
Cignacco E, Hamers JP, Stoffel L, Van Lingen RA, Gessler P, McDougall J, et al. The efficacy of non-pharmacological interventions in the management of procedural pain in preterm and term neonates.: A systematic literature review.
European Journal of pain. 2007 Feb 1;11(2):139-52.
Badiee Z, Asghari M, Mohammadizadeh M. The calming effect of maternal breast milk odor on premature infants. Pediatrics & Neonatology. 2013 Oct 1;54(5):322-5.
Fitri SY, Lusmilasari L, Juffrie M, Bellieni CV. Modified sensory stimulation using breastmilk for reducing pain intensity in neonates in Indonesia: a randomized controlled trial. Journal of Pediatric Nursing. 2020 Jul 1;53:e199-203.
Jonsdottir RB, Kristjansdottir G. The sensitivity of the premature infant pain profile–PIPP to measure pain in hospitalized neonates. Journal of evaluation in clinical practice. 2005 Dec;11(6):598-605.
Grunau RE, Whitfield MF, PetrieThomas J, Synnes AR, Cepeda IL, Keidar A, et al. Neonatal pain, parenting stress and interaction, in relation to cognitive and motor development at 8 and 18 months in preterm infants. Pain. 2009 May 1;143(1-2):138-46.
Johnston CC, Fernandes AM, CampbellYeo M. Pain in neonates is different. Pain. 2011 Mar 1;152(3):S65-73.
Grunau RE. Neonatal pain in very preterm infants: long-term effects on brain, neurodevelopment and pain reactivity. Rambam Maimonides medical journal. 2013 Oct;4(4).
Anand KJ, Aranda JV, Berde CB, Buckman S, Capparelli EV, Carlo W, et al. Summary proceedings from the neonatal pain-control group. Pediatrics. 2006 Mar 1;117(Supplement_1):S9-22.
Küçük Alemdar D, Kardaş Özdemir F. Effects of having preterm infants smell amniotic fluid, mother's milk, and mother's odor during heel stick procedure on pain, physiological parameters, and crying duration. Breastfeeding Medicine. 2017 Jun 1;12(5):297-304.
Şener Taplak A, Erdem E. A comparison of breast milk and sucrose in reducing neonatal pain during eye exam for retinopathy of prematurity. Breastfeeding Medicine. 2017 Jun 1;12(5):305-10.
Johnston CC, Campbell-Yeo M, Filion F. Paternal vs maternal kangaroo care for procedural pain in preterm neonates: a randomized crossover trial. Archives of pediatrics & adolescent medicine. 2011 Sep 5;165(9):792-6.
Simonse E, Mulder PG, van Beek RH. Analgesic effect of breast milk versus sucrose for analgesia during heel lance in late preterm infants. Pediatrics. 2012 Apr.1;129(4):657-63.
Baudesson de Chanville A, BrevautMalaty V, Garbi A, Tosello B, Baumstarck K, Gire C, et al. Analgesic effect of maternal human milk odor on premature neonates: A randomized controlled trial. Journal of Human Lactation. 2017 May;33(2):300-8.
Campbell-Yeo M, Fernandes A, Johnston C. Procedural pain management for neonates using nonpharmacological
strategies: part 2: mother-driven interventions. Advances in Neonatal Care. 2011 Oct 1;11(5):312-8.
Harrison D, Reszel J, Bueno M, Sampson M, Shah VS, Taddio A, et al. Breastfeeding for procedural pain in infants beyond the neonatal period. Cochrane database of systematic reviews. 2016(10).
Rad ZA, Aziznejadroshan P, Amiri AS, Ahangar HG, Valizadehchari Z. The effect of inhaling mother’s breast milk Vohra et al.J Ped Perspect, Vol.12, N.12, Serial No.132, Dec. 2024 19204odor on the behavioral responses to pain caused by hepatitis B vaccine in preterm infants: a randomized clinical trial. BMC pediatrics. 2021 Dec;21:1-6