info/cite needed

When I took my son in for his 2 month WBV, I had decided to give him the DTP
vaccine and to ask the ped's recommendation on HiB and Prevnar. She
convinced me to do both of those . . I don't know if I would still feel so
bad about the experience if it wasn't for what happened after she left and
her nurses came in to give the shots. I had planned to nurse him, or at
least offer the breast, while they gave the injections. But the two nurses
dismissed this idea out of hand, and said it would be impossible for them to
do their job this way. I detached and handed him over . . I felt so sorry
for the little guy, even though they were very fast.
I was furious when I talked to a friend the next day and she said that at
her 2 month visit (with a different pediatrician) the nurses encouraged her
to breastfeed during the injections! I looked around in the archives and
found a few mentions that this is indeed beneficial, but I'd really like to
be able to cite a study when I speak with my ped about this. I know if it's
out there, you guys can find it.

On a related note - anyone know where I can find info on the "uptake rate"
of various vaccines? I know that the multiple-series injections are given
because a certain percentage of children do not have sufficient immune
response to first or subsequent shots. For example, the first shot covers
70%, the second an additional 10%, the third 4%, etc etc. Are there other
reasons for additional shots (besides "boosters" years later).
If my boy has a 70% (or whatever it is) chance of being covered by just one
shot, there's no way I'm putting him through another 4 or 5 of the same!
Thanks for your help,
Hannah

I vaguely recall there having been a study in the past year or so that
had something to do with breastfeeding and response to pain while bf.
I'm thinking it was even noted in little snippets in mainstream news
magazines like Time and such. I think the among the conclusions was the
idea of bf during injections indeed being a good idea. Sorry not to be
more helpful than a lot of vagueries.

That said, and granted we have done selected and delayed vax schedule, I
always nursed ds through shots, and simply did not entertain any other
notion. I just picked him up, climbed up on the exam table, asked them
where they wanted to do the injection, arranged him accordingly and
latched him on, all with the attitude that this is indeed how this will
happen or it won't happen at all. There was not asking, and it most
certainly can be done.

-Karen, mom to Henry 3 3/4 and someone due 4/24/04-

On Thu, 18 Mar 2004 18:36:56 GMT, Luna wrote:

I looked around in the archives and found a few mentions that this is
indeed beneficial, but I'd really like to be able to cite a study when I
speak with my ped about this. I know if it's out there, you guys can
find it.

Analgesic effect of breast feeding in term neonates: randomised controlled
trial

Ricardo Carbajal, Soocramanien Veerapen, Sophie Couderc, Myriam Jugie,
Yves Ville

Objectives: To investigate whether breast feeding is effective for pain
relief during venepuncture in term neonates and compare any effect with
that of oral glucose combined with a pacifier.

Design: Randomised controlled trial.

Participants: 180 term newborn infants undergoing venepuncture; 45 in each
group.

Interventions: During venepuncture infants were either breast fed (group
1), held in their mother's arms without breast feeding (group 2), given 1
ml of sterile water as placebo (group 3), or given 1 ml of 30% glucose
followed by pacifier (group 4). Video recordings of the procedure were
assessed by two observers blinded to the purpose of the study.

Main outcome measures: Pain related behaviours evaluated with two acute
pain rating scales: the Douleur Aiguë Nouveau-né scale (range 0 to 10) and
the premature infant pain profile scale (range 0 to 18).

Results: Median pain scores (interquartile range) for breast feeding, held
in mother's arms, placebo, and 30% glucose plus pacifier groups were 1
(0-3), 10 (8.5-10), 10 (7.5-10), and 3 (0-5) with the Douleur Aiguë
Nouveau-né scale and 4.5 (2.25-8), 13 (10.5-15), 12 (9-13), and 4 (1-6)
with the premature infant pain profile scale. Analysis of variance showed
significantly different median pain scores (P0.0001) among the groups.
There were significant reductions in both scores for the breast feeding
and glucose plus pacifier groups compared with the other two groups
(P0.0001, two tailed Mann-Whitney U tests between groups). The difference
in Douleur Aiguë Nouveau-né scores between breast feeding and glucose plus
pacifier groups was not significant (P=0.16).

Conclusions: Breast feeding effectively reduces response to pain during
minor invasive procedure in term neonates.

BMJ 2003;326:13 ( 4 January )

available on-line at:

http://bmj.bmjjournals.com/cgi/content/full/326/7379/13

--
Deb