Effect of expressed breast milk and oral sucrose administration on pain and stress levels during sternal dressing in newborns who had open heart surgery

The study was conducted as a double-blind, randomized, controlled experimental study to evaluate effect of expressed breast milk and oral sucrose administration during sterna dressing in newborns who had open heart surgery. The study population was comprised of newborns who had open heart surgery in cardiovascular intensive care unit between June 2022 and October 2022, and the study sample was comprised of 45 newborns meeting the sample selection criteria. The newborns were divided into 3 groups with computer-assisted randomization with random crossover: those who received expressed breast milk (Group 1; n=15), those who received oral sucrose (Group 2; n=15), and those who received placebo (distilled water) (Control group; n=15) during dressing. For the newborns, these 3 methods were applied in different orders during first 3 sternal dressings. Pain and stress levels of the newborns before, during and 1, 5 and 15 minutes after dressing were independently evaluated by two observer nurses by using ALPS-NEO scale (pain) and Neonatal Stress scale (stress). A p<0.05 was considered statistically significant. Compared for pain levels, there were no differences in pain levels before dressing between the groups, whereas it was found that pain levels of the groups which received expressed breast milk during and after 1, 5 and 15 minutes had lower pain levels compared to the sucrose and control groups (p<0.001), with no significant difference between sucrose and control groups (p>0.05). Compared for stress levels, the groups were found to have similar stress levels before dressing (p>0.05), whereas it was determined that pain scores in the group which received expressed breast milk during and 1, 5, and 15 minutes after dressing were lower compared to the sucrose and control groups (p<0.001), and that stress levels of the sucrose group during and 1 minute after the procedure were found to be similar, whereas they were significantly lower than the control group at 5 and 15 minutes (p<0.001). In conclusion, breast milk is more effective in reducing pain and stress during sternal dressing in newborns, compared to sucrose. Sucrose administration contributed reduction of stress levels of the newborns in a short period of time but failed to reduce pain level. Breast milk should be considered as the first option for reducing pain and stress levels induced by sternal dressing in newborns.