The influence of breastfeeding on cortical and bio-behavioral indicators of procedural pain in newborns

Shortly after babies are born, they have to experience painful procedures, such as Vitamin K injections and heel pokes for blood collection, to ensure that they are healthy. When left untreated, this early pain exposure is associated with adverse consequences, such as increased pain response during later procedures. There is growing evidence regarding the effectiveness of sweet taste and other non-pharmacologic strategies, such as breastfeeding, in lowering behavioral indicators of pain. However, recent concerns have been raised regarding the ability of sweet taste to lower response to pain in the infant brain. No studies to date have examined the effect of breastfeeding on pain response in the newborn brain. Thus, the proposed study will address this significant knowledge gap by examining to what extent breastfeeding impacts on pain, specifically, pain-specific brain activity during an acute painful procedure (i.e., a heel lance) in comparison to sweet taste (24% oral sucrose). This study will also compare the similarities and differences between pain-specific brain activity and bio-behavioral pain indicators in this patient population. Sixty healthy full term infants will be recruited within two days of birth and randomized to receive either 1) breastfeeding (n = 30) or 2) sucrose (n = 30) during a medically indicated heel lance for blood collection. Pain-specific brain activity will be recorded on electroencephalogram (EEG) for the duration of the procedure. Behavioral and physiologic indicators of pain will also be obtained. Findings will have important implications for informing optimal pain assessment and management practices in newborns.