Newborns perceive pain, and several non- pharmacologic analgesic methods have been used during painful procedures. Activation of the neonatal somatosen- sory cortex, in association with a painful procedure without analgesia, has been demonstrated by two-channel near-in- frared spectroscopy (NIRS). Objectives: To evaluate both cortical and behavioural responses of healthy term new- borns to a painful procedure during two non-pharmacolog- ic analgesic interventions, i.e. glucose solution and breast- feeding. Methods: The effects of glucose and breastfeeding on pain-associated neonatal cortical activity were studied in two groups (n = 30) by multichannel NIRS during a heel prick. Cortical activation was identified by variations in oxygenat- ed haemoglobin. Neonatal pain expression was assessed by a validated scale. Results: No significant variations in cortical activity emerged using glucose solution, whereas breastfed newborns showed widespread cortical activation. Breastfed neonates showed significantly less behavioural pain expres- sion. Conclusions: Glucose is associated with no significant
cortical activation and may interfere with pain-associated re- sponse at the cortical level. Conversely, breastfeeding anal- gesia is associated with generalized cortical activation and may act by multisensory stimulation, possibly overwhelm-
ing pain perception
