Letter to the Editor
Breastfeeding Attenuates Crying of a Distressed Infant
S. Songül Yalçin
I read with great interest the recent article by Sabety et al,1 who reported that breast milk was better for pain reduction before venipuncture. Several methods have been reported to reduce pain and discomfort associated with injection and venipuncture, such as holding, swaddling them, sucking on a pacifier, diversion of attention or giving sweet solutions (such as sucrose or glucose).2,3 As mentioned in the article,1 some methods (sucrose/glucose or pacifier) might interfere, regular breastfeeding schedule.1,4 Indeed, among the analgesics studied for procedural pain, breastfeeding/ breast milk is a natural, easily available, and easy to use intervention.3 As a limitation, how the intervention might work was not discussed in the article.1 There are several potential mechanisms by which breast milk or breast feeding might provide an analgesic effect.3 One of the possible explanation is that breast milk contains a higher concentration of tryptophan, a precursor of melatonin. Also, breastmilk is one of the sweetest milk in the world, contains 7% lactose. Not only the content of breast milk, but also breastfeeding is important to soothe infants and toddlers. Also, pain is relieved in human newborns when they are exposed to odors from their mother's milk.3 It was reported that breastfeeding, providing sucking and physical sensation (skin-to-skin contact with mother), gave superior analgesia to other kinds of non-pharmacological analgesia in healthy term neonates during heel prick.5 Breastfeeding is capable of attenuating crying of a distressed infant. Therefore, it would be better to add breastfeeding as a key component to manage pain and anxiety associated with procedures for infants and toddlers.
S. Songül Yalçin
Department of Pediatrics,
Unit of Social Pediatrics,
Hacettepe University Faculty of Medicine,
1. Sabety F, Yaghoobi M, Torabizadeh M, Javaherizadeh H, Haghighizadeh MH, Mohammadian F, et al. Which is better for pain reduction before venipuncture: glucose, lidocaine or expressed breast milk? HK J Paediatr (New Series) 2013;18:19-23.
2. Bueno M, Yamada J, Harrison D, Khan S, Ohlsson A, Adams-Webber T, et al. A systematic review and meta-analyses of nonsucrose sweet solutions for pain relief in neonates. Pain Res Manag 2013;18:153-61.
3. Yalçin SS. Breast-feeding for the management of painful procedures. J Pediatr Hematol Oncol 2012;34:322-3.
4. Karabulut E, Yalçin SS, Ozdemir-Geyik P, Karaaağaoğlu E. Effect of pacifier use on exclusive and any breastfeeding: a meta-analysis. Turk J Pediatr 2009;51:35-43.
5. Marín Gabriel MÁ, del Rey Hurtado de Mendoza B, Jiménez Figueroa L, Medina V, Iglesias Fernández B, Vázquez Rodriquez M, et al. Analgesia with breastfeeding in addition to skin-to-skin contact during heel prick. Arch Dis Child Fetal Neonatal Ed 2013;98:F499-503.