Effect of expressed breast milk, swaddling and facilitated tucking methods in reducing the pain caused by orogastric tube insertion in preterm newborns

Objective: The aim of this study was to evaluate the efficacy of the use of expressed breast milk, swaddling and facilitated tucking methods alone and combination in reducing the pain caused by Orogastric Tube (OGT) insertion in preterm newborns. Method: The study was a randomized, double-blind and controlled experimental study. This study was conducted between November 2017-2018 in the three Neonatal Intensive Care Units in Antalya. A total of 187 preterm newborns, which consist of control group (n=33), swaddling group (n=30), facilitated tucking (n=32), expressed breast milk (n=31), swaddling+expressed breast milk group (n=30), and facilitated tucking+expressed breast milk group (n=31) were included into the study. As data collection tools; Preterm Neonatal Descriptive Form, Physiological Measurement Form and Premature Infant Pain Profile (PIPP) were used. Preterms were recorded with the video camera before, during and after the OGT installation process. Video recordings were examined by two pain specialists, blind to the intervention, and PIPP evaluation was performed. For statistical analysis of the study data, two-way analysis of variance for the multiple repeated measurements, shapiro-wilk, paired-sample t-test, bonferroni, Generalised Estimating Equation (GEE) logistic regression model were used. Results: When groups were compared in terms of their genders, gestation ages, postnatal ages and body weight, no statistically significant difference was found between them (p>0,05). On the PIPP scale, inter- specialist consistency reliability was> 0.90. In the study, it was determined that the breast milk group had 6.074, the facilitated tucking group had 5.914, the facilitated tucking+expressed breast milk group had 2.968, the control group had 12.396 and the swaddling group had 7.385 times more pain compared to the swaddling+expressed breast milk (p<0.005). Conclusion: It is recommended that the OGT insertion which is a painful procedure should be used as a combined the swaddling+expressed breast milk and nurses to be trained about the methods. Key words: pain, preterm, premature, orogastric tube, newborn nurse.