Clinical Health Updates

Breastfeeding during immunization reduces infant crying

Clinical Question:
Does breastfeeding during immunization reduce infant pain?

Bottom Line:
Infants cry less when breastfed at the time of immunization. Other indicators of pain, including heart rate and oxygen saturation, were unchanged with breastfeeding compared with no breastfeeding.

Efe E, Ozer ZC. The use of breast-feeding for pain relief during neonatal immunization injections. Applied Nursing Research 2007:20:10-16.

Study Design:
Randomized controlled trial (nonblinded)

The authors examined the pain-relieving effect of breast-feeding during immunization injections in healthy neonates. Sixty-six healthy infants returning to a clinic for their second-, third-, or fourth-month immunization with intramuscular diphtheria, tetanus, and pertussis were randomized to be breast-fed before, during, and after the injection or to be given the injection according to routine clinic procedure (no breast-feeding). To assess the pain responses of the neonates during and after immunization, they noted their heart rates, oxygen saturation levels, and length of crying. The crying time was shorter in the experimental (breast-feeding) group (M +/- SD duration, 35.85 +/- 40.11 seconds) than in the control group (M +/- SD duration, 76.24 +/- 49.61 seconds; p = .001). The heart rate and oxygen saturation levels were almost the same in both groups. We concluded that breast-feeding, maternal holding, and skin-to-skin contact significantly reduced crying in infants receiving an immunization injection for diphtheria, tetanus, and pertussis.