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 "Our primary goal was to give parents information that in general
they don't normally learn from anyone: how to soothe babies when
they are in distress," said study leader Anna Taddio, a professor in
the Leslie Dan Faculty of Pharmacy at the University of Toronto and
a senior associate scientist at the Hospital for Sick Children.
"Parents tell us that it is quite stressful for them when their
children have painful procedures done."
To discover whether simple education methods could help parents
learn to soothe babies during a painful procedure like vaccination,
Taddio and her colleagues recruited 3,420 mothers of newborns while
they and the babies were still in the hospital.
As reported in CMAJ, the researchers randomly assigned moms to one
of three groups. All three groups received a pamphlet and a video
about the importance of vaccinations. But one group also received a
pamphlet describing three strategies for soothing babies' pain. And
another group got the pain pamphlet plus a video showing how to use
the techniques.
The strategies for soothing infants' pain were breast feeding,
giving them sugar syrup and applying a topical anesthetic.
When the children were two, four and six months old, the researchers
asked the moms what types of calming strategies were used when the
babies got vaccinations. By six months, 2,549 moms were still
participating in the study.
Fifty-three percent of moms who didn't get the pain-control
educational materials said they had given babies sugary syrup,
breastfed or used an over the counter anesthetic. Among moms who
received an educational pamphlet, however, 61 percent used one of
those strategies. And among those who got a pamphlet and a video, 63
percent used one of the methods.
That meant that 15 percent to 19 percent more women used pain
soothing strategies when given education months before their babies'
vaccinations.
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The babies aren't the only ones to benefit from this kind of
educational intervention, said Dr. Lonnie Zeltzer, a distinguished
professor of pediatrics, anesthesiology, psychiatry and behavioral
sciences at the David Geffen School of Medicine at the University of
California, Los Angeles.
"By giving the parents these strategies to help their children, we
are helping the parents mitigate their own anxieties and fears about
pain exposure in their babies," Zeltzer said. "And that, in turn can
help the child feel calmer and less reactive and alarmed. We know
from other studies that when someone is alarmed more adrenaline is
produced. And if there is more adrenaline, there is an increase in
sensory signals and an increase in the volume of pain signals. From
that standpoint, this can be a major help for parents."
Beyond that, earlier studies done by Taddio showed that in some
children, pain can change brain wiring. "Repeated pain exposure can
create central pain circuits that make kids more pain sensitive,"
Zeltzer said.
But if the child is distracted from the pain, that brain rewiring is
less likely to occur, Zeltzer said. And the distraction isn't that
hard to manage, she added.
"In the early 80s I showed that if you can get children involved
with a good story, a good enough distractor to hold the child's
attention, you could get the brain focus shifted and that actually
reduces the pain," Zeltzer said.
SOURCE: http://bit.ly/2ysRxgI CMAJ, online October 22, 2018.
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