Vanilla essence non-nutritive sucking, an effective alternative for pain relief during heel-stick procedure in healthy term neonates: A randomized clinical trial

Objective: The aim of this study is to compare the efficacy of breastfeeding (BF) with non-nutritive sucking (NNS) using a vanilla-scented pacifier as an intervention to relieve pain in healthy term neonates during the heel-stick procedure. Materials and methods: This was a randomized clinical trial of healthy term infants randomly assigned to one of two groups. In both groups, the assigned non-pharmacological method was provided 1 min before the heel stick and up to 5 min after the procedure, which was recorded on video, as well as measures of vital signs of the newborn necessary for the use of the Premature Infant Pain Profile (PIPP) scale. A neonatologist was responsible for giving a score to each newborn in the PIPP scale to measure pain after the procedure. The primary outcome is to compare the PIPP scores in the two groups. Results: A sample of 40 infants were analyzed, of which 21 (52.5%) were given NNS and 19 (47.5%) BF. It was found that PIPP scores do not differ between the intervention group and the control group: (median [interquartile range]) 12 (7.50-13.50) and 11 (11-13), respectively, (p = 0.61). Conclusions: BF and NNS are equally effective in controlling pain in term infants during heel stick procedure. While we recommend BF due to its well-known benefits, NNS could be used when BF is not available