Table 2.

Evidence for parent-delivered interventions: expressed breastmilk.

Author (year), country	Study design	Population, setting	Type of pain, intervention	Key findings
Simonse et al. (56), Netherlands	RCT	71 preterm neonates, GA 32–37 weeks, NICU	Heel lance, breast milk (either breastfed or bottle-fed) vs. oral sucrose	No difference in PIPP score between neonates receiving breast milk and those receiving sucrose
Nanavati et al. (57), India	RCT	50 VLBW infants, NICU	Adhesive tape removal, a swab soaked in expressed breast milk was held in the infant's mouth from 2 min before tape removal vs. SSC mother	PIPP score indicated minor or no pain. No difference compared to the SSC group
Bembich et al. (47), Italy	RCT	80 term newborns, nursery	Heel stick, (1) oral glucose on changing table, (2) maternal expressed breast milk on changing table (2 ml), (3) maternal holding plus oral glucose, and (4) breastfeeding	No significant effect on NIPS score for expressed breastmilk compared with maternal holding or glucose
Hatami Bavarsad et al. (50), Iran	RCT	100 full-term infants, maternity ward	Vaccination, expressed breastmilk vs. breastfeeding vs. powdered formula group vs. control group (no feeding)	No significant effect on DAN score compared with the breastfeeding group

RCT, randomized control trial; GA, gestational age; NICU, neonatal intensive care unit; PIPP, premature infant pain profile; VLBW, very low birth weight; NIPS, Neonatal Infant Pain Scale.