@article {10801, title = {Infant Analgesia With a Combination of Breast Milk, Glucose, or Maternal Holding.}, journal = {Pediatrics}, volume = {142}, year = {2018}, month = {2018 Sep}, abstract = {

OBJECTIVES: We studied neonatal cortical brain response to 4 types of nonpharmacological analgesia (oral glucose, expressed breast milk, maternal holding plus oral glucose, breastfeeding). We aimed to assess the differential effect of oral solutions (glucose, breast milk) given alone or combined with the maternal-infant relationship (holding, breastfeeding).

METHODS: Eighty healthy term newborns undergoing a heel stick were randomly assigned to 4 parallel groups of 20 infants each: group 1, infants received a glucose solution on a changing table; group 2, infants received expressed breast milk on a changing table; group 3, infants received a glucose solution in their mothers{\textquoteright} arms; and group 4, infants were breastfed by their mothers. Cortical activation in parietal, temporal, and frontal cortices was assessed by multichannel near-infrared spectroscopy. Pain expression was also evaluated.

RESULTS: Oral glucose alone or combined with maternal holding was associated with no cortical activation during heel stick. Expressed breast milk was associated with localized bilateral activation of somatosensory and motor cortices ( < .01). Breastfeeding was associated with extensive bilateral activation of somatomotor, somatosensory, and right parietal cortices ( < .01). Pain expression was lower with the maternal-infant relationship ( = .007).

CONCLUSIONS: Oral glucose, either alone or combined with maternal holding, appears to block or weaken cortical pain processing. Breast milk alone is associated with localized cortical activation. Breastfeeding is associated with extensive activation and may act by extending cortical processing. Maternal relationship, both combined with oral glucose and in breastfeeding, shows the greatest analgesic effect, although the neural patterns involved are distributed differently.

}, issn = {1098-4275}, doi = {10.1542/peds.2017-3416}, author = {Bembich, Stefano and Cont, Gabriele and Causin, Enrica and Paviotti, Giulia and Marzari, Patrizia and Demarini, Sergio} } @article {3630, title = {Making the first days of life safer: preventing sudden unexpected postnatal collapse while promoting breastfeeding.}, journal = {J Hum Lact}, volume = {31}, year = {2015}, month = {2015 Feb}, pages = {47-52}, abstract = {

Early and prolonged skin-to-skin contact (SSC) after birth between a mother and her newborn has been shown to generate beneficial effects on the mother-infant relationship and breastfeeding. Close mother-infant body contact immediately after birth positively enhances exclusive breastfeeding during the hospital stay, with a dose-response relationship. Skin-to-skin contact may ease the infant{\textquoteright}s transition to extra-uterine life and helps regulate the infant{\textquoteright}s body temperature and nursing behavior. However, reports of sudden unexpected postnatal collapse (SUPC) soon after birth, in healthy term neonates, in association with SSC, have raised concerns about the safety of this practice. Based on available evidence, we developed a surveillance protocol in the delivery room and postnatal ward of the Institute for Maternal and Child Health of Trieste (Italy). The aim of our protocol is (a) to promote safe mother and infant bonding and (b) to establish successful breastfeeding, without increasing the risk of SUPC. As there is no known effective intervention to prevent SUPC, our protocol has been conceived as a potential best practice.

}, issn = {1552-5732}, doi = {10.1177/0890334414554927}, author = {Davanzo, Riccardo and De Cunto, Angela and Paviotti, Giulia and Travan, Laura and Inglese, Stefania and Brovedani, Pierpaolo and Crocetta, Anna and Calligaris, Chiara and Corubolo, Elisa and Dussich, Valentina and Verardi, Giuseppa and Causin, Enrica and Kennedy, Jaquelyn and Marrazzo, Francesca and Strajn, Tamara and Sanesi, Cecilia and Demarini, Sergio} }