Comparison of Breast Milk and Sucrose in Neonatal Pain Relief and Coping with Stress of ROP Examination Using ALPS-Neo

Document Type : Original Article


1 School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran. Women’s Health Research Institute, Department of OBGYN, University of British Columbia, Vancouver, Canada

2 Canada Research Chair in Neonatal Health and Development, Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada

3 School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran

4 Massachusetts Eye and Ear Harvard Medical School, Department of Ophthalmology, Boston, Massachusetts, the United States. Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran

5 Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.. Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, Iran

6 School of Public Health and Paraclinics, Qazvin University of Medical Sciences, Qazvin, Iran


Background: Examination for retinopathy of prematurity (ROP) is one of the procedures that can be stressful for neonates admitted to a neonatal intensive care unit. This study compared breast milk and sucrose in pain relief and coping with the stress of ROP examination using the Astrid Lindgren and Lund Children’s Hospital Pain and Stress Assessment Scale for Preterm and Sick Newborn Infants (ALPS-Neo).
Methods: The present study was carried out on a total of 63 preterm infants (including breast milk group [n=21], sucrose group [n=21], and distilled water group [n=21]). The neonates were given 0.5 ml/kg of breast milk, sucrose, or distilled water 2 min before the examination. The ROP eye examinations were video recorded from 5 min before to 15 min after the examination, and infants’ pain and stress levels were assessed using the ALPS-Neo by two blinded evaluators 5 min before, during, and 5, 10, and 15 min after the examination.
Results: No statistically significant differences were observed during the examinations in the mean scores of the ALPS-Neo among the three groups (P>0.05). However, there were statistically significant differences among the three groups after the examinations (p <0.05) and in the mean duration of stress adaptation (p <0.05). The duration of stress adaptation in the breast milk group was 11.4 min on average which was lower than that reported for the other groups.
Conclusion: Breast milk was more effective in the reduction of pain and stress after ROP examinations, compared to sucrose or distilled water.


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