The effect of breastfeeding on reducing pain induced by pentavalent vaccine in infants: a randomized clinical trial.
Glenda Lyara Ribeiro Queiroz, Maria Augusta Rocha Bezerra, Ruth Cardoso Rocha and 4 others
PMID 39264089WHAT IT FOUND
Breastfeeding five minutes before and during a pentavalent vaccine lowered infant behavioral pain scores to 3.83, compared with 6.06 when breastfeeding stopped before injection and 7.43 with no breastfeeding.
Key findings
01Average FLACC pain scores were 3.83 with breastfeeding for five minutes before and during vaccination, 6.06 with breastfeeding for five minutes only before vaccination, and 7.43 with no breastfeeding.
02In paired comparisons, the before-and-during breastfeeding group was reported as significantly lower than control, and more effective than breastfeeding only before.
03Pain categories in the before-and-during breastfeeding group were 14 mild, 14 moderate, and 2 strong, compared with none mild, 8 moderate, and 22 strong in control.
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How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study could not blind mothers or researchers to breastfeeding, so behavioral pain scores may be affected by expectations. It was done in one region of Brazil, so it may not apply to other settings. Pain was assessed only with the FLACC behavioral scale, not with objective physiological measures. The trial used cluster randomisation and multiple trained vaccinators, not one vaccinator for all participants. It included only infants around two months old receiving their first pentavalent dose who were already breastfeeding directly. The paper's text and table are inconsistent about whether breastfeeding only before vaccination differed from control: the text says only the before-and-during group was significant, while the table reports p=0.006 for the before-only group versus control.
The easy way to misread this
Do not conclude that breastfeeding only before vaccination is as effective as breastfeeding during vaccination. The paper reported the before-and-during group as significantly lower than control, and the before-only group still averaged 6.06 on the FLACC scale, compared with 7.43 in control.