Publication:

Effectiveness of breastfeeding on pain level during heel prick among neonates: a true experimental study

Background Heel prick is the most common painful procedure performed on healthy term neonates. Repeated untreated procedural pain in the neonatal period is associated with long-term adverse neurodevelopmental outcomes and altered pain thresholds. Breastfeeding is a well-established non-pharmacological analgesic, yet remains underutilized in Indian hospital settings. This study aimed to assess the effectiveness of breastfeeding on pain during heel prick among healthy term neonates.

Methods A true experimental post-test only design was employed. Sixty healthy term neonates (gestational age 37–42 weeks, postnatal age 0–5 days, birth weight ≥2500 g) admitted to the postnatal ward of Civil Hospital, Dehradun, India, were randomly allocated to an experimental group (n=30) receiving breastfeeding during heel prick and a control group (n=30) receiving routine care. Pain was assessed using the validated Neonatal Infant Pain Scale (NIPS).

Results The mean NIPS score was significantly lower in the experimental group (2.03±0.809) compared to the control group (5.80±1.095; t=15.152, p<0.001). In the experimental group, 73.3% of neonates experienced mild-to-no pain and none experienced severe pain, whereas 86.7% of controls experienced severe pain. A statistically significant association was observed between sex and pain level (χ²=6.140, p=0.046).

Conclusions Breastfeeding is a highly effective, safe and cost-free non-pharmacological analgesic for procedural pain in healthy term neonates. Breastfeeding analgesia should be formally integrated into neonatal pain management protocols in Indian hospitals, with structured nursing training to support implementation.