Efficacy of Dextrose Versus Breast Milk on Pain and Comfort in Neonates Undergoing Heel Lance: A Pilot Study

Background Heel-lance procedures are routinely performed in neonates for blood sampling but are known to cause significant pain and distress. Managing procedural pain in newborns is essential not only to ensure immediate comfort but also to promote positive early interactions with healthcare. This study aimed to assess the effectiveness of 25% dextrose and expressed breast milk in reducing pain and enhancing comfort in neonates undergoing heel-lance procedures. Methods A quasi-experimental study with pre-test post-test design was undertaken in Lumbini Provincial Hospital and Siddhartha Women and Children Hospital of Lumbini Province, Nepal. A total of 14 neonates admitted to the intensive care unit and meeting the eligibility criteria were taken as the sample of the study. The neonates were assigned to two groups. i.e., intervention group (n=7) who received 2 mL of 25% glucose and control group who received 2ml of breast milk (n=7), two minutes before the heel-lance procedure. Pain and comfort were assessed using the Premature Infant Pain Profile-Revised (PIPP-R) and the Modified Comfort Behaviour Scale (MCBS) at baseline and following the lancing procedure. PIPP-R and MCBS scales were validated with reliability coefficients of 0.76 and 0.82, respectively. The data was analysed descriptively and inferentially using a parametric test. Results The mean birth weight of the neonates was 2920 ± 430 grams. Post-intervention analysis showed that the mean PIPP-R score was significantly lower in the 25% dextrose group (3.5 ± 0.78) compared to the expressed breast milk group (8.57 ± 1.51) (P < 0.01), indicating greater pain relief in the dextrose group. Similarly, discomfort levels at 2- and 4-minute post-procedure were significantly reduced in the dextrose group across both sessions (p < 0.01). A strong positive correlation was observed between post-procedural pain and discomfort scores (r = 0.84, p < 0.01), suggesting that higher pain was associated with greater discomfort. Conclusion The study findings indicate that 25% dextrose is more effective than expressed breast milk in reducing pain and discomfort in neonates undergoing heel-lance procedures. Incorporating 25% dextrose as a simple, safe, and effective pain management strategy can enhance neonatal comfort during routine clinical interventions.