Efficacy of breast-feeding in pain relief against pain induced by two vaccines administered from two different injection sites in two-month-old infants

In this randomized, controlled, and experimental study, our aim was to investigate the efficacy of breast-feeding in pain relief against pain caused by 2 vaccines administered consecutively from 2 different injection sites (right and left vastus lateralis muscles) in 2-month-old infants. The study data were collected from the infants who presented to the Vali Saim Cotur Family Health Center (No. 3), Antalya Provincial Directorate of Health between July 1, 2012 and November 25, 2012. The randomization of the study sample was performed via systematic random sampling (sealed envelope method). While 50 infants that were vaccinated during breast-feeding constituted our experimental group, 50 infants who underwent routine vaccination procedure constituted the control group. A total of 100 infants were included in our study. The study group included infants who received breast-feeding 5 minutes before, during, and after the vaccination. The control group received nothing other than the routine procedure. Data collection was performed using a survey form including descriptive information about the infants, a `pulse oximetry device? to measure physiologic signs such as oxygen saturation and heart rate, a video camera (Sony DSC-HC21) to record the visuals of crying and behavioral changes in infants, and Neonatal Infant Pain Scale (NIPS) to evaluate the behavioral responses of the infants during vaccine administration. Our study was started after obtaining the legal permissions from the Local Ethics Committee at the Akdeniz University Health Sciences Institute. All the healthcare workers in the related Family Health Center, the family health practitioner administering the vaccines, and the parents of the infants included in the study were informed about the aim and procedures of the study. Written and verbal informed consents were gained from all the mothers of the infants enlisted in our study. The statistical analyses were carried out with SPSS (Statistical Package for Social Sciences) v20.0 package program. The study results were expressed as percentage, mean, and standard deviation values along with using chi-square test and Cronbach?s alpha coefficient, while the intergroup analyses were performed by Independent Samples t-test and Mann-Whitney U test. A p value ?0.05 was recognized as statistically significant. In this study, the babies who received breast-feeding during vaccine administration demonstrated lower heart rates, higher oxygen saturation values, and shorter duration of crying. All these physiologic findings show that babies who are breastfed during vaccine injection feel less pain. Furthermore, the breast-feeding group exhibited lower pre- and post-procedural mean NIPS scores. Breast-feeding was observed to reduce the behavioral changes associated with vaccine administration. We concluded that breastfeeding was effective in reducing the pain suffered during vaccine injection in infants. The infants who received their vaccine in combination with breast-feeding were observed to experience less pain. Keywords: newborn, infant, pain, vaccine administration, non-pharmacological methods, nurse