BMJ 2000;320:1002 ( 8 April )

Letters

Analgesic effects of sweet solutions and pacifiers in term neonates

    Suckling at the breast is better than sweet solutions and pacifiers
    Use of pacifier may modify responses measured on rating scale
    Surely evidence is not needed to justify cuddling babies in pain
    Measures of pain must be validated in young children
    Trial of drug treatment to alleviate pain in neonatal intubation is needed
    Authors' reply

Suckling at the breast is better than sweet solutions and pacifiers

The first 150 words of the full text of this article appear below.

EDITOR---A breastfeeding mother spontaneously comforts her distressed infant by putting him or her to the breast. It is a pity that Carbajal et al, when assessing the analgesic effects of orally administered glucose and sucrose in healthy term neonates, did not include a comparison group of infants given breast milk, which is rich in lactose and naturally sweet.1 It would also have been appropriate to compare the analgesic effect of using a pacifier with that of suckling at the breast before and immediately after the painful procedure.

Pacifiers and sugar solutions given unnecessarily to healthy neonates are not proved to be "simple and safe interventions," as Carbajal et al state. Exclusive breast feeding (for about the first six months) is the World Health Organization's recommendation.2 Two of the evidence based "ten steps to successful breastfeeding," developed by the WHO/Unicef Baby Friendly Hospital Initiative, are step 6 ("Give newborn infants . . . [Full text of this article]
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