Skip to main content
Top
Published in: BMC Pediatrics 1/2021

Open Access 01-12-2021 | Hepatitis B | Research article

The effect of inhaling mother’s breast milk odor on the behavioral responses to pain caused by hepatitis B vaccine in preterm infants: a randomized clinical trial

Authors: Zahra Akbarian Rad, Parvin Aziznejadroshan, Adeleh Saebi Amiri, Hemmat Gholinia Ahangar, Zahra Valizadehchari

Published in: BMC Pediatrics | Issue 1/2021

Login to get access

Abstract

Background

Nowadays, it is generally assumed that non-pharmacologic pain relief in preterm infants is an important measure to consider. Research findings suggest that familiar odors have soothing effects for neonates. The aim of this study was to compare the effect of maternal breast milk odor (MBMO) with that of another mother’s breast milk odor (BMO) on the behavioral responses to pain caused by hepatitis B (HB) vaccine injection in preterm infants.

Methods

This single-blind randomized clinical trial was performed over the period between February 2019 and March 2020 in the neonatal intensive care unit of Babol Rouhani Hospital, Iran. Ninety preterm infants, who were supposed to receive their HB vaccine, were randomly assigned into three groups: MBMO (A), another mother’s BMO (B), and control with distilled water(C). Oxygen saturation (SaO2), blood pressure (BP) and heart rate (HR) were recorded for all participants through electronic monitoring. In addition, premature infant pain profiles (PIPP) were determined through video recording for all three groups during intervention. The chi-square, ANOVA and ANCOVA were used for analyzing the data, and P < 0.05 was considered significant in this study.

Results

No significant differences were found between the three groups in mean ± SD of HR, BP, and Sao2 before the intervention (P > 0.05). After the intervention, however, the means for heart rate in groups A, B, and C were 146 ± 14.3, 153 ± 17.5 and 155 ± 17.7, respectively (P = 0.012). Moreover, the means for PIPP scores in groups A, B and C were 6.6 ± 1.3, 10 ± 2, and 11.4 ± 1.9, respectively (P < 0.001). There was no significant difference found between groups in their means of SaO2, systolic and diastolic blood pressure after the intervention (P > 0.05).

Conclusions

The results indicate that stimulation with MBMO is effective in reducing pain in preterm infants; therefore, it can be postulated that this technique can be considered in less invasive procedures such as needling.

Trial registration

IRCT, IRCT201902200427​71N1. Registered 18 May 2019- Retrospectively registered,
Literature
1.
go back to reference Majidipour N, Nirouzad F, Sarrafzade S, Kalani L, Aghababaeian H, Haghighat BS. The effect of holy Quran recitation on the physiological responses of premature infants during phlebotomy: a randomized clinical trial. Int J Pediatr. 2018;6(7):7869–81. Majidipour N, Nirouzad F, Sarrafzade S, Kalani L, Aghababaeian H, Haghighat BS. The effect of holy Quran recitation on the physiological responses of premature infants during phlebotomy: a randomized clinical trial. Int J Pediatr. 2018;6(7):7869–81.
2.
go back to reference Sajjadi M, Basirimoghadam M, Amiri SE. Effect of breast Milk odor on physiological and behavioral pain responses caused by hepatitis B vaccine in full-term infants. Horizon Med Sci. 2017;23(3):169–73. Sajjadi M, Basirimoghadam M, Amiri SE. Effect of breast Milk odor on physiological and behavioral pain responses caused by hepatitis B vaccine in full-term infants. Horizon Med Sci. 2017;23(3):169–73.
3.
go back to reference Grunau RE. Long term effects of pain-related stress on neurodevelopment and pain perception of infants born very prematurely. Enfance. 2013;1:15–31.CrossRef Grunau RE. Long term effects of pain-related stress on neurodevelopment and pain perception of infants born very prematurely. Enfance. 2013;1:15–31.CrossRef
4.
go back to reference Stadtlander L. Understanding Infant Pain. Int J Childbirth Educ. 2018;33(2):6–8. Stadtlander L. Understanding Infant Pain. Int J Childbirth Educ. 2018;33(2):6–8.
5.
go back to reference Verklan MT, Walden M, Forest S. Core curriculum for neonatal intensive care nursing e-book: Elsevier health sciences; 2020. Verklan MT, Walden M, Forest S. Core curriculum for neonatal intensive care nursing e-book: Elsevier health sciences; 2020.
6.
go back to reference Jebreili M, Rasouli AS, Hosseini MB, Gojazade M, Esfahlani HN. The effect of breast Milk odor in venipuncture pain in preterm infants: randomized controlled clinical trial. Majallah-i pizishki-i Danishgah-i Ulum-i Pizishki va Khadamat-i Bihdashti-i Darmani-i Tabriz. 2016;38(3):42. Jebreili M, Rasouli AS, Hosseini MB, Gojazade M, Esfahlani HN. The effect of breast Milk odor in venipuncture pain in preterm infants: randomized controlled clinical trial. Majallah-i pizishki-i Danishgah-i Ulum-i Pizishki va Khadamat-i Bihdashti-i Darmani-i Tabriz. 2016;38(3):42.
7.
go back to reference Seraji A, Vakilian K. The comparison between the effects of aromatherapy with lavender and reathing techniques on the reduction of labor pain. Complement Med J. 2011;1(1):34–41. Seraji A, Vakilian K. The comparison between the effects of aromatherapy with lavender and reathing techniques on the reduction of labor pain. Complement Med J. 2011;1(1):34–41.
8.
go back to reference Iranmanesh S, Shamsi A, Pour Aboli B, Movahedi Z. The effect of breast milk odor on transition time from gavage to oral feeding and hospital stay in premature infants. ICAN: Infant Child Adolesc Nutr. 2015;7(1):5–11.CrossRef Iranmanesh S, Shamsi A, Pour Aboli B, Movahedi Z. The effect of breast milk odor on transition time from gavage to oral feeding and hospital stay in premature infants. ICAN: Infant Child Adolesc Nutr. 2015;7(1):5–11.CrossRef
9.
go back to reference Marofi M, Nikobakht F, Ali MN, Badiei Z. Comparing the effect of listening to melody vs. breast-feeding on neonates’pain intensity during heel-blood sampling in neonatal intensive care unit; 2015. Marofi M, Nikobakht F, Ali MN, Badiei Z. Comparing the effect of listening to melody vs. breast-feeding on neonates’pain intensity during heel-blood sampling in neonatal intensive care unit; 2015.
10.
go back to reference Holsti L, Oberlander TF, Brant R. Does breastfeeding reduce acute procedural pain in preterm infants in the neonatal intensive care unit? A randomized clinical trial. Pain. 2011;152(11):2575–81.CrossRef Holsti L, Oberlander TF, Brant R. Does breastfeeding reduce acute procedural pain in preterm infants in the neonatal intensive care unit? A randomized clinical trial. Pain. 2011;152(11):2575–81.CrossRef
11.
go back to reference Nishitani S, Miyamura T, Tagawa M, Sumi M, Takase R, Doi H, et al. The calming effect of a maternal breast milk odor on the human newborn infant. Neurosci Res. 2009;63(1):66–71.CrossRef Nishitani S, Miyamura T, Tagawa M, Sumi M, Takase R, Doi H, et al. The calming effect of a maternal breast milk odor on the human newborn infant. Neurosci Res. 2009;63(1):66–71.CrossRef
12.
go back to reference Badiee Z, Asghari M, Mohammadizadeh M. The calming effect of maternal breast milk odor on premature infants. Pediatr Neonatol. 2013;54(5):322–5.CrossRef Badiee Z, Asghari M, Mohammadizadeh M. The calming effect of maternal breast milk odor on premature infants. Pediatr Neonatol. 2013;54(5):322–5.CrossRef
13.
go back to reference Küçük Alemdar D, Kardaş ÖF. Effects of having preterm infants smell amniotic fluid, mother's milk, and mother's odor during heel stick procedure on pain, physiological parameters, and crying duration. Breastfeed Med. 2017;12(5):297–304.CrossRef Küçük Alemdar D, Kardaş ÖF. Effects of having preterm infants smell amniotic fluid, mother's milk, and mother's odor during heel stick procedure on pain, physiological parameters, and crying duration. Breastfeed Med. 2017;12(5):297–304.CrossRef
14.
go back to reference Ranjbar A, Bernstein C, Shariat M, Ranjbar H. Comparison of facilitated tucking and oral dextrose in reducing the pain of heel stick in preterm infants: a randomized clinical trial. BMC Pediatr. 2020;20:1–9.CrossRef Ranjbar A, Bernstein C, Shariat M, Ranjbar H. Comparison of facilitated tucking and oral dextrose in reducing the pain of heel stick in preterm infants: a randomized clinical trial. BMC Pediatr. 2020;20:1–9.CrossRef
15.
go back to reference Stevens BJ, Gibbins S, Yamada J, Dionne K, Lee G, Johnston C, et al. The premature infant pain profile-revised (PIPP-R): initial validation and feasibility. Clin J Pain. 2014;30(3):238–43.CrossRef Stevens BJ, Gibbins S, Yamada J, Dionne K, Lee G, Johnston C, et al. The premature infant pain profile-revised (PIPP-R): initial validation and feasibility. Clin J Pain. 2014;30(3):238–43.CrossRef
16.
go back to reference Gibbins S, Stevens BJ, Yamada J, Dionne K, Campbell-Yeo M, Lee G, et al. Validation of the premature infant pain profile-revised (PIPP-R). Early Hum Dev. 2014;90(4):189–93.CrossRef Gibbins S, Stevens BJ, Yamada J, Dionne K, Campbell-Yeo M, Lee G, et al. Validation of the premature infant pain profile-revised (PIPP-R). Early Hum Dev. 2014;90(4):189–93.CrossRef
17.
go back to reference Zhang S, Su F, Li J, Chen W. The analgesic effects of maternal milk odor on newborns: a meta-analysis. Breastfeed Med. 2018;13(5):327–34.CrossRef Zhang S, Su F, Li J, Chen W. The analgesic effects of maternal milk odor on newborns: a meta-analysis. Breastfeed Med. 2018;13(5):327–34.CrossRef
18.
go back to reference Aziznejad P, Zahed Pasha Y, Ahmadpour Kacho M, Haji Ahmadi M, Mohammadzadeh I, Arzani A, et al. Comparing the effect of oral sucrose, breast milk and EMLA cream on acute pain during venipuncture in full term neonates. J Babol Univ Med Sci. 2013;15(3):16–23. Aziznejad P, Zahed Pasha Y, Ahmadpour Kacho M, Haji Ahmadi M, Mohammadzadeh I, Arzani A, et al. Comparing the effect of oral sucrose, breast milk and EMLA cream on acute pain during venipuncture in full term neonates. J Babol Univ Med Sci. 2013;15(3):16–23.
Metadata
Title
The effect of inhaling mother’s breast milk odor on the behavioral responses to pain caused by hepatitis B vaccine in preterm infants: a randomized clinical trial
Authors
Zahra Akbarian Rad
Parvin Aziznejadroshan
Adeleh Saebi Amiri
Hemmat Gholinia Ahangar
Zahra Valizadehchari
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2021
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-021-02519-0

Other articles of this Issue 1/2021

BMC Pediatrics 1/2021 Go to the issue