PURPOSE: This study compared the pain-relieving effects of human milk, sucrose, and distilled water during examinations for retinopathy of prematurity. METHODS: Forty-five preterm infants were randomly assigned to receive a pacifier dipped in one of three solutions: human milk (n=14), 24% sucrose (n=15), or distilled water (n=16), 2 minutes before an eye examination. Their pain score, pulse rate, and oxygen saturation were measured at three time points: 5 minutes before the examination, 30 seconds after speculum introduction, and 2 minutes after the examination. RESULTS: The infants' mean gestational age and weight at birth were 33.1±2.1 weeks and 1,842±470 g, respectively. There were no between-group differences in pain relief during the eye examination. The pain score significantly increased both during (p<.001) and after the examinations (p=.003). Oxygen saturation decreased during the examinations (p<.001); however, the infants in the 24% sucrose group showed higher oxygen saturation (p=.047) during the examinations than the infants in the other groups. CONCLUSION: Sucking on a pacifier dipped in human milk or 24% sucrose did not reduce the pain associated with eye examinations in preterm infants. Pacifiers dipped in sucrose can be used to maintain better oxygen saturation during these examinations.
Analgesia ; Gestational Age ; Heart Rate ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Milk, Human ; Oxygen ; Pacifiers ; Parturition ; Retinopathy of Prematurity ; Sucrose ; Surgical Instruments ; Water

PURPOSE: The goal of this study was to compare the efficacy of oral 25% dextrose treatment or/and pacifier for analgesia in healthy newborns during intramuscular injection of a hepatitis B vaccine. METHODS: A prospective, randomized, partially blinded, clinical trial was performed in 132 healthy newborns. They were assigned randomly to 4 treatment groups: control group (2 mL distilled water), dextrose group (2 mL 25% dextrose), pacifier group, dextrose+ pacifier group (pacifier coating with 25% dextrose) during intramuscular injection of hepatitis B vaccine. For all groups, Neonatal Infant Pain Scale (NIPS), Neonatal Facial Coding System (NFCS), Premature Infant Pain Profile (PIPP) scores were evaluated before the injection, during the injection, and at 2 minutes after the injection. Pain scores were compared among the 4 groups. RESULTS: Maternal and neonatal characteristics were similar among the 4 groups. 25% dextrose treatment led to lower NIPS pain scores during injection (6.4+/-0.9 vs. 5.5+/-1.7, P=0.01) and after injection (1.6+/-2.0 vs. 0.6+/-0.9, P=0.01) and NFCS pain scores after injection (1.5+/-2.3 vs. 0.7+/-0.8, P=0.04) than control group. The number of neonates who feel the pain (indication of scores: NIPS> or =4, NFCS> or =3) decreased (9 (23.1%) vs. 0 (0%), P=0.04 via NIPS, 7 (17.9%) vs. 0 (0%), P=0.02 via NFCS). However, all treatment groups did not decreased PIPP scores, compared with the control group. CONCLUSION: Oral 25% dextrose is effective than distilled water or using pacifier with or without 25% dextrose in reducing pain during intramuscular injection of hepatitis B vaccinations. Further study based on this preliminary study need about nonpharmacologic management of pain in newborns.
Analgesia ; Clinical Coding ; Glucose ; Hepatitis B ; Hepatitis B Vaccines ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Injections, Intramuscular ; Pacifiers ; Prospective Studies ; Spiperone ; Vaccination ; Water

PURPOSE: Recurrent otitis media (ROM) is usually defined as > or =3 distinct and well-documented episodes within 6 months or > or =4 episodes within 12 months. ROM is sufficiently important to warrant consideration of chemoprophylaxis, tympanostomy tube placement. There also is evidence that children with ROM are at risk for both hearing loss and speech delay. However, studies of ROM have been notably insufficient. In addition, even though environmental, racial, and sociocultural differences can affect risk factors, few studies have been conducted with regard to recurrent otitis media in Korea. METHODS: This study was conducted from July 2009 to January 2010 with infants and children who were younger than 60 months old, who visited the out-patient clinics at Han-Il General Hospital and Kyunghee University Hospital. Data were collected by interview using a pre-formed sheet. Among a total of 892 infants and children, 457 were excluded, and the remaining 435 were allocated to 104 with ROM and 331 as a control group. RESULTS: Attendance at daycare centers (P<0.001, OR=2.85), allergic rhinitis (P=0.026, OR=2.32), past history of bronchiolitis (P=0.003, OR=2.33), and low socioeconomic status (P=0.005, OR=2.00) were found to have a close significant correlation with ROM. Risk factors such as sex, having a sibling, breast-feeding, use of pacifiers, atopy, pneumococcal vaccination, influenza vaccination, smoking of parents, and indoor smoking are not relevant. CONCLUSION: Attendance at daycare centers, allergic rhinitis, past history of bronchiolitis, and low socioeconomic status have been identified as risk factors for ROM.
Bronchiolitis ; Chemoprevention ; Child ; Hearing Loss ; Hospitals, General ; Humans ; Infant ; Influenza, Human ; Language Development Disorders ; Middle Ear Ventilation ; Otitis ; Otitis Media ; Outpatients ; Pacifiers ; Parents ; Rhinitis ; Rhinitis, Allergic, Perennial ; Risk Factors ; Siblings ; Smoke ; Smoking ; Social Class ; Vaccination

PURPOSE: We compared the pain reducing effect of orally administered glucose solution with EMLA cream and pacifiers during venipuncture in newborn infants. METHODS: Fifty newborn infants(30 prematures) were enrolled in this study. We performed these four pain-reducing methods to all infants in serial order. Group A(control) did not receive any treatment; to group B, EMLA cream was applied on the skin for 1 hour; group C(or D) received 10 percent(or 30 percent) glucose solution orally; group E used pacifiers. Symptoms and signs associated with pain at venipuncture were measured with the Premature Infants Pain Profile(PIPP) scale. RESULTS: There was no significant difference in the PIPP scores between preterm and fullterm infants. The mean PIPP scores of groups were A:12.5+/-2.5, B:10.1+/-2.6, C:9.4+/-2.0, D:6.5+/-2.1 and E:8.7+/-2.3; the mean scores of groups B, C, D and E were significantly lower than that of group A(all, P<0.001 except B(P<0.05)), and the mean score of D was significantly lower than those of B, C and E(P<0.001, P<0.005, P<0.05, respectively). The percentages of patients with PIPP scores above 6, which means pain, were A:100 percent, B:82 percent, C:56 percent, D:40 percent and E:70 percent. The percentages of patients with PIPP scores above 12, which means severe pain, were A:72 percent, B:30 percent, C:22 percent, D:0 percent and E:14 percent; that of group D was clearly lowest. CONCLUSION: These results support the use of oral glucose solution, EMLA, and pacifiers for pain reduction as effective intervention at venipuncture in newborn infants. The most effective method was a 30 percent oral glucose solution.
Glucose* ; Humans ; Infant ; Infant, Newborn* ; Infant, Premature ; Pacifiers* ; Phlebotomy* ; Skin

PURPOSE: This study was to investigate the effects of non-nutritive sucking on physiological and behavioral state of pre-term infants during tube feeding. METHOD: This nonequivalent, non-synchronized experimental study included 50 pre-term infants. An attempt was made to match gestational age and birth weight of infants in each group. Infants in the experimental group were given a pacifier 2 minutes before, during, and for 2 minutes after tube feeding. Infants in the control group did not get a pacifier. Both groups were tested at three stages for changes in the physiologic state and behavioral state-2 minutes before, during, and 2 minutes after feeding. Date was analyzed with SPSS WIN 10.0 using an chi-square-test, t-test, and repeated measures ANOVA. RESULT: Heart rates and oxygen saturation levels of the two groups were significantly different(P=.001, P=.000). The behavioral states of the two groups were significantly different during and post feeding(P=.000, P=.000). CONCLUSION: This result suggests non-nutritive sucking by using a pacifier is an effective intervention for pre-term infants during tube feeding.
*Enteral Nutrition ; Female ; Heart Rate ; Humans ; Infant ; Infant Behavior/*physiology/psychology ; Infant Care ; Infant, Newborn ; Infant, Premature/*physiology/psychology ; Male ; Oxygen Consumption ; *Pacifiers

PURPOSE: This study is to assess and compare the analgegic effects of 25% sucrose coating pacifier and pacifier. METHOD: The participants are 75 healthy infants of neonatal age 1-7 days and randomized to receive heel prick before 2 minutes to blood sampling and physiological test in Nursery of A Medical Center from 24, January to 28, February, 2003. The experimental group assigned to one of three treatment groups: no treatment, a pacifier, 25% sucrose coating pacifier. Collected data were analyzed with the SPSS 11.0 program using Chi square-test, one-way ANOVA and Scheffe, repeated mesured ANOVA. RESULTS: The pain score of 25% sucrose coating pacifier is lower than no treatment group and pacifier group. In heart rate, there were statistical significant differences between three groups. In repiratory rate, there were no statistical significant differences between three groups. In SaO2, there were statistical significant difference between three groups. CONCLUSION: The 25% sucrose coating pacifier showed pain relief effect in behavior responses and heart rate and SaO2. Accordingly, the sucrose coating pacifier should be applied nursing intervention for simple pain management as heel prick.
Heart Rate ; Heel ; Humans ; Infant ; Infant, Newborn* ; Nurseries ; Nursing ; Pacifiers* ; Pain Management ; Sucrose* ; Child Health

PURPOSE: Newborns may undergo many kinds of minor procedures. Since painful events during procedures may cause adverse effects on growth and/or development, nonpharmacological way to relive pain have been extensively studied including oral glucose and pacifiers. This study was undertaken to evaluate the analgesic effects of orally administered glucose and pacifiers in term neonates during minor procedures using validated behavioral pain rating system. METHODS: Randomized prospective studies with 81 term infants were assigned to one of three treatment groups: placebo (2 ml sterile water), glucose (2 ml 30% glucose), and pacifier (2 ml 30% glucose followed by a pacifier) during heelsticks. Intensity of pain was assessed by Douleur Aigue Nouveau-ne scale (DAN scale). RESULTS: Median pain scores (interquartile) during minor procedure and after 30 seconds were 7 (6-10), 4 (3-8) for sterile water; 7 (3-8), 1 (0-5) for 30% glucose; 4 (2-6), 1 (0-1) for 30% glucose and pacifiers, respectively. P values for comparisons of sterile water versus 30% glucose, and 30% glucose versus 30% glucose plus pacifiers were 0.019, 0.035 for during the procedure and 0.006, 0.034 for after 30 seconds, respectively. CONCLUSION: The analgesic effect of oral glucose during minor procedure is clinically apparent in full term neonates. Pacifiers plus glucose have a synergetic analgesic effect in neonates. These simple and safe interventions should be widely used during minor procedures in term neonates.
Glucose* ; Humans ; Infant ; Infant, Newborn* ; Pacifiers* ; Prospective Studies ; Water

OBJECTIVEAlthough nonnutritive sucking (NNS) during tube feeding has some benefits on the physiology and development of premature infants, the effect on gastrointestinal function remains controversial. The aim of the study was to evaluate the effects of NNS on the gastric emptying and gastroesophageal reflux (GER) in premature infants.

METHODSThirty eight healthy appropriate-for-gestational-age premature infants (birth weight ranged from 1050 g to 1790 g, gestational age ranged from 28 weeks to 35 weeks) accepting intermittent nasogastric feeding (INGF) were randomized into NNS group and N-NNS group according to INGF with and without NNS and fed with the same milk formula. Group NNS (n = 18) received oral stimulation by means of a pacifier immediately before feeding, during feeding and then after feeding for 5 min. Group N-NNS (n = 20) served as control and received INGF alone. The following data were collected and recorded, the fluid intake (including both intravenous and oral), milk intake, caloric intake, time of caloric intake reaching 418.4 kJ/(kg x d) by enteral feeding and relevant condition to feeding. Gastric emptying was measured when oral intake reaching above 8 ml/kg while concurrently measuring 24 hour esophageal pH. Real time ultrasonic images of the gastric antrum were obtained and the antral cross sectional area (ACSA) was measured and the half emptying time (50% DeltaACSA) was calculated. Using 24-hour intraesophageal pH monitoring for evaluation of GER, the five parameters of esophageal pH were recorded: number of reflux episodes during 24 hours, reflux index, number of episodes lasting > 5 min, the duration of longest episode and the total time of pH < 4.0.

RESULTSWithin two weeks after feeding, there was no significant difference in the fluid intake, caloric intake between the two groups (P > 0.05). Gastric emptying was measured on day 13.26, milk intake had no difference between the two groups and there was no difference in prefeed ACSA. The half gastric emptying time in NNS group was significantly shorter than that in N-NNS group [(58.33 +/- 22.94) min vs. (73.75 +/- 17.76) min, P < 0.05]. Thirty-two of the 38 infants developed GER, the morbidity was 84.2%; the number of reflux episodes during 24 hours was significantly fewer in NNS group than that in N-NNS group [9 (2 - 31) vs. 14 (5 - 31), P < 0.05]; the total time pH < 4.0 and reflux index was lower in NNS than that in N-NNS, but the difference was not statistically significant. The time of reaching 418.4 kJ/(kg x d) by enteral feeding in NNS group was significantly shorter than that in N-NNS group [(12.36 +/- 4.29) d vs. (15.50 +/- 4.58) d, P < 0.05]. The incidence of feeding intolerance such as vomiting and abdominal distension was lower in NNS group than that in N-NNS group, but the difference was not statistically significant (P > 0.05). However, the morbidity of gastric residue in NNS was significantly lower than that in N-NNS (16.7% vs 50.0%, respectively, P < 0.05).

CONCLUSIONNNS used during intermittent nasogastric tube feeding is an easy and safe intervention. NNS can improve gastric emptying and decrease the number of reflux episodes, has a positive improving effect on the development of gastrointestinal motility, is beneficial to premature infants for establishing postnatal enteral nutrition.

Enteral Nutrition ; Gastric Emptying ; physiology ; Gastroesophageal Reflux ; physiopathology ; prevention & control ; Gastrointestinal Motility ; physiology ; Humans ; Infant Formula ; Infant Nutritional Physiological Phenomena ; physiology ; Infant, Newborn ; physiology ; Infant, Premature ; physiology ; Pacifiers ; Sucking Behavior

PURPOSE: An inexperienced mother depends on the recommendation by an experienced person on how to bring up her child. Therefore, we performed a study to evaluate the wrong methods of childcare and to establish effective childcare counselling. METHODS: Two thousand eighty questionnaires filled out by mothers who visited local pediatric clinics and medical centers in Chonbuk, from March 2001 to April 2001, were analyzed according to the distribution of location, age of infant, maternal age and the question of each field. RESULTS: Many mothers have been known to squeeze the breast causing hypertrophy of the neonate. Most infants are placed on their side or supine for sleep. The most common reason for stopping breast feeding was insufficient amount of breast milk. The appropriate age to start whole cow's milk is after the first year of life. The main food used for weaning was commercial baby food. The main oral hydration solution for diarrhea has been boiled water. The main reasons for using a pacifier were to help the mother. The most common reason to use herbs was for the prevention of disease. The use of infant walkers has been widespread among infants and young children. The most common reason was to keep the infant quiet and happy. Most mothers did not use car safety seats for young children. CONCLUSION: The findings of this study revealed that many mothers were misinformed concerning childcare, so pediatricians should make more efforts and perform more studies to establish rational methods of childcare.
Breast ; Breast Feeding ; Child ; Diarrhea ; Humans ; Hypertrophy ; Infant ; Infant Equipment ; Infant, Newborn ; Jeollabuk-do ; Maternal Age ; Milk ; Milk, Human ; Mothers ; Pacifiers ; Surveys and Questionnaires ; Water ; Weaning

The ability of neonates to perceive and react to pain, has been acknowledged recently. Recent researches have been shown that even short term pain can have lasting negative effects. We know that most of the anatomical pathway and neurotransmitter function necessary for pain perception are fully or nearly fully developed in the neonatal period. Many people are still reluctant to believe that pain felt by neonates may be as severe as that felt by older children or adults yet. The objective of the study is to assess and compare the analgesic effects of orally administered sucrose and pacifiers. And to determine the synergistic analgesic effects of sucrose and pacifiers. The tools for this study is Lawrence's NIPS (neonatal infant pain scale) with behavioural pain responses and index for pain physiological reponses as heart rate, respiratory rate and degree of SaO2. The participants are 96 healthy infants of neonatal age 1-7days and randomised to receive heel prick before 2minutes to blood sampling and physiological test in Nursery of K Medical University Hospital on May-July, 2000. The experimental group assigned to one of three treatment groups : no treatment; a pacifier; placebo(2ml 25% sucrose). Collected data were analyzed with the SAS program using X2-test, ANOVA and Duncan's multiple range test as post hoc. The results were as follows. 1) Pain behaviour responses: The pain score of placebo group(2ml 25% sucrose) is lower than no treatment group and pacifier group significantly(P=.000). Placebo group is different from no treatment and pacifier group with Duncan's multiple range test. 2) Pain physiologic responses (1) heart rate: The heart rate of placebo group(2ml 25% sucrose) is different from that of no treatment group and pacifier group significantly(P=.000). The heart rate change of placebo group is less than the other groups. (2) respiratory rate: The respiratory rate of placebo group(2ml 25% sucrose) is different from that of no treatment group and pacifier group insignificantly (P=.2340). But, the respiratory rate of placebo group is lower than the other groups. (3) SaO2: The SaO2 score of placebo group(2ml 25% sucrose) is different from that of no treatment group and pacifier group insignificantly (P=.3265). But, the change of SaO2 score of placebo group is less than the other groups. In conclusion, the sucrose placebo showed pain relief effect in behavior responses and less physiological responses. Accordingly, the sucrose placebo should be applied nursing intervention for simple pain management as heel prick.
Adult ; Child ; Heart Rate ; Heel ; Humans ; Infant ; Infant, Newborn* ; Neurotransmitter Agents ; Nurseries ; Nursing ; Pacifiers ; Pain Management ; Pain Perception ; Respiratory Rate ; Sucrose* ; Child Health