Comparative Effects of Dextrose and Breast Milk on Physiological Parameters and Crying Duration Among Neonates Undergoing Heel Prick: A Quasi-experimental Study

TL;DR

This study compares dextrose and breast milk for reducing pain during heel pricks in newborns, finding dextrose more effective.

Contribution

Demonstrates that 25% dextrose is more effective than expressed breast milk in reducing neonatal pain during heel pricks.

Findings

Dextrose group showed faster stabilization of physiological parameters compared to breast milk group.

Crying duration was significantly shorter in the dextrose group during heel pricks.

Abstract

Background

Heel pricks are a common but painful procedure in neonatal care, often causing significant distress. Effective pain management is not only essential for the neonate's comfort but also a fundamental ethical obligation of healthcare providers, reflecting a commitment to compassionate and neonatal care. This study aims to compare the effects of dextrose and expressed breast milk in relieving procedural pain, as measured by changes in vital parameters and the duration of crying among neonates while undergoing heel prick.

Methods

A quasi-experimental study was conducted in selected hospitals of Lumbini Province, Nepal, from February 15 to July 2024 among 140 neonates admitted to the neonatal intensive care unit. The neonates were allocated to two groups: the intervention group (n=70), which received 2 mL of 25% glucose, and the expressed breast milk group (n=70), which received 2 mL of expressed breast milk, which was administered two minutes before the heel prick procedure. Physiological parameters were assessed using a biophysiological assessment proforma at baseline and following the heel prick procedure. The biophysiological assessment proforma was validated with reliability coefficients of 0.80. Data analysis was done descriptively and inferentially using non-parametric tests.

Results

The mean birth weight of neonates was 3.07 ± 0.41 kg in the dextrose group and 3.00 ± 0.40 kg in the expressed breast milk group. Vital parameters (heart rate, respiratory rate, and oxygen saturation) stabilized significantly faster in the dextrose group (p < 0.05). The Wilcoxon signed-rank test further confirmed significant within-group changes in physiological parameters across different time points, with a greater effect observed in the dextrose group. In addition, crying duration was shorter in the dextrose group compared to the breast milk group during both heel pricks: 73.14 ± 26.47 vs. 112.85 ± 17.99 seconds for the first heel prick and 67.42 ± 18.23 vs. 98.43 ± 17.33 seconds for the second heel prick.

Conclusion

The study demonstrates that 25% dextrose more effectively stabilized the physiological parameters with less crying duration than expressed breast milk during heel prick.