Analgesic Role of Breastfeeding: Analysis of Effectiveness, Implementation Barriers, and Strategies to Promote Evidence-Based Practice

Objective: Exposure to painful stimuli serves as toxic stress for infants, increasing their subse-quent pain sensitivity and resulting in neurodevelopmental impairments. Besides offering nutri-tional, psychological, immunological, and economic benefits, breastfeeding is reported as the most effective analgesia for the management of minor procedural pain in infants. Although breastfeeding holds several advantages, implementation of this nonpharmacological intervention is still uncommon in many clinical settings. Methods: This scoping review presents an analysis of 29 clinical trials that compare the effec-tiveness of breastfeeding with other nonpharmacological methods. Findings: Breastfeeding is an efficacious analgesia compared with sucrose, sweet solutions, and other nonpharmacological methods. When used alone or in combination with other nonpharma-cological interventions, breastfeeding reduces infants' biobehavioral responses to pain and pro-motes faster physiologic recovery after painful procedures. Breastfeeding is recommended as the first choice whenever feasible. Barriers to the uptake of this effective pain management method in clinical practice include misinformation/inconsistent use of evidence, an infant's impaired suck-ing reflex, maternal-child separation, the workload of healthcare professionals, a lack of parental involvement, assumptions of healthcare providers, and a lack of adequate information/guidance for parents. Strategies to promote the uptake of breastfeeding for the management of procedural pain in infants include an effective partnership between healthcare providers and breastfeeding mothers, knowledge mobilization resources in multiple languages, informational support and media campaigns, and experiential learning opportunities for breastfeeding mothers. Conclusions: Successful implementation of baby-friendly hospital initiatives, a patient-centered approach, family-centered care, and the collaborative efforts of healthcare providers in all health-care settings is recommended to promote the uptake of breastfeeding as analgesia.