Comparing the effect of swaddling and breastfeeding and their combined effect on the pain induced by BCG vaccination in infants referring to Motahari Hospital, Jahrom, 2010-2011

Fatemeh Hashemi; Laila Taheri; Fariba Ghodsbin; Narjes Pishva; Mehrdad Vossoughi

doi:10.1016/j.apnr.2015.05.013

Comparing the effect of swaddling and breastfeeding and their combined effect on the pain induced by BCG vaccination in infants referring to Motahari Hospital, Jahrom, 2010-2011

Appl Nurs Res. 2016 Feb:29:217-21. doi: 10.1016/j.apnr.2015.05.013. Epub 2015 May 30.

Authors

Fatemeh Hashemi¹, Laila Taheri², Fariba Ghodsbin¹, Narjes Pishva³, Mehrdad Vossoughi⁴

Affiliations

¹ Fatemeh (P.B.U.H) College of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
² Fatemeh (P.B.U.H) College of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran. Electronic address: taheri.leila@ymail.com.
³ Neonatalogy Research Center, Department of Pediatrics, Namazee Hospital, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
⁴ Department of Dental Public Health, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.

PMID: 26856517
DOI: 10.1016/j.apnr.2015.05.013

Abstract

Background and aim: Despite the clinical importance of pain, many neonates are subjected to numerous painful invasive procedures and their complications as part of their care. This study has been designed to investigate the effect of swaddling and breastfeeding, and their combined effect on the pain induced by BCG vaccination in healthy term infants.

Method: This randomized double-blind intervention study was performed on 131 healthy term neonates in Motahari Hospital of Jahrom. The samples were randomly assigned into three intervention groups and a control group. The infants in the swaddled group were swaddled 2 minutes before and 2 minutes after vaccination. The infants in the breastfed group were breastfed within 45 minutes before vaccination. The infants in the combination group were both breast fed before and swaddled within vaccination but the infants in the control group were vaccinated without any intervention. Heart rate and oxygen saturation level of neonates were recorded in the 3 phases of: baseline, injection and 2 minutes after injection. Furthermore, the neonates' faces were recorded using a video camera. Then pain intensity was measured by Neonatal Facial Coding System (NFCS). Mean Score of pain intensity and physiological responses of subjects were statistically analyzed using non parametrical Kruskal-Wallis test and Mann-Whitney.

Results: The mean of pain intensity (NFCS) and changes in the heart rate at injection time to the baseline in the three intervention groups in comparison with the control group showed statistically significant difference (p=0.003 and p=0.002 respectively). However changes in blood oxygen saturation level, were not statistically significant difference between four groups.

Conclusion: Regarding to the significant impact of both breastfeeding and swaddling on the pain reduction of vaccination, it is recommended to take benefit of these two safe and available non-pharmacological methods in order to relief pain during painful procedures.

Keywords: BCG vaccine; Breastfeeding; Neonates; Pain; Swaddling.

Publication types

Comparative Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

BCG Vaccine / administration & dosage*
Bedding and Linens / adverse effects*
Breast Feeding*
Double-Blind Method
Humans
Infant Care / methods*
Infant, Newborn
Pain / physiopathology*
Vaccination / adverse effects

Substances

BCG Vaccine