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.

Citations

• Effects of fentanyl and sucrose on pain in retinopathy examinations with pain scale, near-infrared spectroscopy, and ultrasonography: a randomized trial
  Nursu Kara, Didem Arman, Zeynep Seymen, Adem Gül, Serdar Cömert
  World Journal of Pediatrics.2023; 19(9): 873.     CrossRef
• Non-pharmacological pain relief interventions in preterm neonates undergoing screening for retinopathy of prematurity: a systematic review
  Iretiola Bamikeolu Fajolu, Iyabode Olabisi Florence Dedeke, Beatrice Nkolika Ezenwa, Veronica Chinyere Ezeaka
  BMJ Open Ophthalmology.2023; 8(1): e001271.     CrossRef
• Effect of non-nutritive sucking on pain during the examination of retinopathy of prematurity
  Tuba Koç Özkan, Elif Didem Yüksel, Selahattin Akar
  Journal of Neonatal Nursing.2022; 28(3): 155.     CrossRef
• Effect of Prone Position, Pacifier and Smelling Breast Milk on Pain and Stress Parameters Among Term Neonates Undergoing Venipuncture: A Randomized Controlled Trail
  Fuat Özdemir, Derya Evgin, Nalan Gördeles Beşer
  The Journal of Pediatric Research.2022; 9(2): 146.     CrossRef
• Effectiveness of Gentle Human Touch for Pain Control During Examination for Retinopathy of Pre-maturity: A Randomized Controlled Trial
  Yongping Sun, Jinghan Zhang, Xu Chen, Yang Yang, Jie Qiu, Ke-yu Lu, Rui Cheng
  Frontiers in Pediatrics.2020;[Epub]     CrossRef

Purpose
The study was done to investigate behavioral problems in toddlers who were born prematurely and to analyze related factors.
Methods
A cross-sectional explorative study was conducted with 72 preterm birth (PTB) children at 24 to 41 months of corrected age who were born at 28 to 37 weeks’ gestation. During home visits, behavior problems were assessed using the Behavior Rating Index for Children (BRIC). Using a BRIC score of ≥30, children with suspected behavior problems were grouped in the non-regular behavior group.
Results
Of the children, 38.9% belong to the non-regular behavior group. The mental development index score for the Korean-Bayley Scale of Infant Development-II was higher for the non-regular behavior group compared to the regular behavior group (t = 2.26, p = .027). Logistic regression analysis showed that lower maternal attachment (<96, OR=3.4, 95% CI[1.1, 10.4]) and higher parenting stress (≥97, OR=4.8, 95% CI[1.3, 17.3]) were independently related to non-regular behavior.
Conclusion
PTB Toddlers are at risk for behavior problems which are associated with low cognitive performance. Maternal-child attachment and maternal parenting stress were strongly related to behavior problems in these children. More attention is needed to understand possible behavior problems in young children with PTB, particularly focusing on maternal-child interaction and maternal mental well-being.

Citations

• Validation of the Korean Version of the Maternal Postpartum Attachment Development Scale for Mothers of Children who were in a Neonatal Intensive Care Unit
  Ah Rim Kim, Young Ran Tak
  Korean Journal of Child Studies.2018; 39(1): 129.     CrossRef
• Factors Influencing Parenting Stress in Mothers of Preschoolers Born Prematurely
  Sangmi Lee
  Child Health Nursing Research.2017; 23(4): 470.     CrossRef

We studied the effects of nonnutritive sucking(NNS) on lingual lipase activity and body weight under bottle feeding with 17 premature infants hospitalized . NNS was applied to nine infants and other eight infants comprised the control group. Pacifiers were applied to the experimental group for 5 minutes before and after bottle feeding. The treatment took approximately 20-25 minutes each time including bottle feeding time and was applied 7 times a day at intervals of 3 hours and for consecutive ten days. Lingual lipase activity and body weight were measured on the first, third, seventh and tenth day. Results and Conclusion : 1. Lingual lipase activity was low at 30 minutes after feeding and then began to increase reaching its highest level at 120 and 180 minutes after the feeding in both group. 2. Lingual lipase activity in the experimental group was not higher than that of the control group on the third, seventh and tenth day. 3. Body weight increased in experimental and control groups as days passed, while it was not significantly different between groups. These results lead to conclusion that among premature infants under bottle feeding, NNS is not effective in increasing the lingual lipase for fat digestion and NNS is not also effective for increasing body weight. The application of NNS to premature infants under bottle feeding needs considerable judgement for promoting well-being of nursing goals.

Prematurity is the main cause for respiratory disorders in neonates. The goal in respiratory management is to maintain respiration with adequate oxygenation. Chest vibration(CV) prior to endotracheal suctioning(ETS) has been arbitrarily applied to ventilated premature infants without the scientific evaluation of its safety and efficacy. A repeated measure within subjects experimental study was conducted to investigate the effects of CV prior to ETS on oxygenation and lung secretions in twenty-one ventilated premature infants. The independent variable was the type of research protocol, the control type(ETS without CV) and the intervention(ETS with CV). The dependent variables were oxygen saturation(SpO2), heart rate (HR), measured by pulse oximeter, and the amount of lung secretions measured in gram, the results showed there was no difference in SpO2 responses regardless CV employed before ETS. But there was a significant difference in HR responses between the control and the intervention, even without clinical significance. There was a significant difference in the amount of lung secretions retrieved during ETS with CV, compared to ETS without CV. This study suggested the safety of CV by demonstrating no clinically significant changes in SoO2 and HR in premature infants. The efficacy of CV could be supported by the increases in the amount of sputum during ETS with CV compared to ETS without CV in premature infants.