Analgesia in newborns: a case-control study of the efficacy of nutritive and non-nutritive sucking stimuli

Analgesia em recém-nascidos: um estudo caso-controle da eficácia dos estímulos de sucção nutritiva e não nutritiva

Ana Henriques Lima Ana Paula Hermont Amélia Augusta de Lima Friche About the authors


PURPOSE: To verify the nutritive and non-nutritive stimuli efficacy in the newborn's response to pain during venipuncture. METHODS: The main sample was composed of 64 newborns that were randomly divided into three groups. The first group (n=20) received nutritive sucking stimulus that was performed through maternal breastfeeding. The second group (n=21) received non-nutritive sucking stimulus that was performed through the introduction of the researcher little finger in the newborn's oral cavity. The third group or control group (n=23) did not receive any analgesia stimulus. The newborns were evaluated using the Neonatal Infant Pain Scale, and the responses to painful stimuli were compared. RESULTS: The nutritive as well as non-nutritive suction methods provided a comforting effect, resulting in lower pain response scores (p<0.05). There was no difference between the analgesia provided by both methods (p>0.05). CONCLUSION: The nutritive and the non-nutritive sucking stimuli proved to be efficacious tools in relieving pain among newborns.

Pain; Analgesia; Sucking behavior; Newborn; Case-control studies

OBJETIVO: Verificar a eficácia dos estímulos de sucção nutritiva e não nutritiva na resposta do recém-nascido à dor durante a punção venosa. MÉTODOS: A amostra principal foi composta por 64 recém-nascidos que foram divididos aleatoriamente em três grupos. O primeiro grupo (n=20) recebeu estímulo de sucção nutritiva, o qual foi realizado através da amamentação materna. O segundo grupo (n=21) recebeu estímulo de sucção não nutritiva, o qual foi realizado através da introdução do dedo mínimo do pesquisador na cavidade oral do recém-nascido. O terceiro grupo ou grupo de controle (n=23) não recebeu qualquer estímulo de analgesia. Os recém-nascidos foram avaliados utilizando a Escala de Dor do Recém-nascido e as respostas aos estímulos dolorosos foram comparadas. RESULTADOS: Ambos os estímulos de sucção proporcionaram efeito analgésico, resultando em respostas a dor menores se comparados ao controle (p<0.05). Não houve diferença entre a analgesia produzida pelos dois estímulos de sucção (p>0.05). CONCLUSÃO: Tanto o estímulo de sucção nutritiva quanto a sucção não nutritiva provaram ser métodos eficazes no alívio da dor em recém-nascidos.

Dor; Analgesia; Comportamento de sucção; Recém-nascido; Estudos de casos e controles

  • 1
    Anand KJ, Hickey PR. Pain and its effects in the human neonate and fetus. N Engl J Med. 1987;317(21):1321-7.
  • 2
    Morton NS. The pain-free ward: myth or reality. Paediatr Anaesth. 2012;22(6):527-9.
  • 3
    Kristjánsdóttir O, Unruh AM, McAlpine L, McGrath PJ. A systematic review of cross-cultural comparison studies of child, parent, and health professional outcomes associated with pediatric medical procedures. J Pain. 2012;13(3):207-19.
  • 4
    American Academy of Pediatrics, Canadian Paediatric Society. Prevention and Management of Pain in the Neonate: An Update. Pediatrics. 2006;118(5):2231-41.
  • 5
    Hardy W. Facilitating pain management. Adv Neonatal Care. 2011;11(4):279-81.
  • 6
    Gaspardo CM, Miyase CI, Chimello JT, Martinez FE, Martins Linhares MB. Is pain relief equally efficacious and free of side effects with repeated doses of oral sucrose in preterm neonates? Pain. 2008;137(1):16-25.
  • 7
    Corff KE, Seideman R, Venkataraman PS, Lutes L, Yates B. Facilitated tucking: a nonpharmacologic comfort measure for pain in preterm neonates. J Obstet Gynecol Neonatal Nurs. 1995;24(2):143-7.
  • 8
    Mathew PJ, Mathew JL. Assessment and management of pain in infants. Postgrad Med J. 2003;79(934):438-43.
  • 9
    Gray L, Miller LW, Philipp BL, Blass EM. Breastfeeding is analgesic in healthy newborns. Pediatrics. 2002;109(4):590-3.
  • 10
    Glass RP, Wolf LS. A global perspective on feeding assessment in the neonatal intensive care unit. Am J Occup Ther. 1994;48(6):514-26.
  • 11
    Hall RW. Anesthesia and analgesia in the NICU. Clin Perinatol. 2012;39(1):239-54.
  • 12
    Lawrence J, Alcock D, McGrath P, Kay J, MacMurray SB, Dulberg C. The development of a tool to assess neonatal pain. Neonatal Netw. 1993;12(6):59-66.
  • 13
    Blass EM. Milk-induced hypoalgesia in human newborns. Pediatrics. 1997;99(6):825-9.
  • 14
    Carbajal R, Chauvet X, Couderc S, Olivier-Martin M. Randomised trial of analgesic effects of sucrose, glucose, and pacifiers in term neonates. BMJ. 1999;319(7222):1393-7.
  • 15
    Stevens B, Johnston C, Petryshen P, Taddio A. Premature infant pain profile: development and initial validation. Clin J Pain. 1996;12(1):13-22.
  • 16
    Butler-O'Hara M, LeMoine C, Guillet R. Analgesia for neonatal circumcision: A randomized controlled trial of EMLA cream versus dorsal penile nerve block. Pediatrics. 1998;101(4):1-5.
  • 17
    Fernandes A, Campbell-Yeo M, Johnston CC. Procedural pain management for neonates using nonpharmacological strategies: Part 1: sensorial interventions. Adv Neonatal Care. 2011;11(4):235-41.
  • 18
    Liu MF, Lin KC, Chou YH, Lee TY. Using non-nutritive sucking and oral glucose solution with neonates to relieve pain: a randomised controlled trial. J Clin Nurs. 2010;19(11-12):1604-11.
  • 19
    Weissman A, Aranovitch M, Blazer S, Zimmer EZ. Heel-lancing in newborns: Behavioral and spectral analysis assessment of pain control methods. Pediatrics. 2009;124(5):921-6.
  • 20
    Zimmerman EA, Barlow SM. The complexity of transitioning to oral feeds in preterm infants. Perspect Speech Sci Orofac Disord. 2009;19(1):52-7.

Publication Dates

  • Publication in this collection
    16 Aug 2013
  • Date of issue


  • Received
    17 Jan 2013
  • Accepted
    05 Feb 2013
Sociedade Brasileira de Fonoaudiologia Al. Jaú, 684, 7º andar, 01420-002 São Paulo - SP Brasil, Tel./Fax 55 11 - 3873-4211 - São Paulo - SP - Brazil