Etri Probowati, Ariawan Soejoenoes, Sri Wahyuni M, Donny Kristanto Mulyantoro, Melyana Nurul Widyawati, Diyah Fatmasari


Background:Immunization in infants is an action that can cause trauma due to injection of the immunization that can cause pain. Breastfeeding and non-nutritive sucking are considered to be non-pharmacologic strategy of pain management.

Objective: This study aims to investigate the effectiveness of breastfeeding and non-nutritive sucking on pain relief in infant immunization

Methods: This was a quasy experimental study with posttest only control group.  This study was conducted on 26 October till 30 November 2016 at hree Community Health Centers (Puskesmas), namely Puskesmas Cilacap Utara I, Puskesmas Cilacap Tengah, and Puskesmas Cilacap Selatan I. The population was infants aged 2-4 months who got immunization of DPT-HB-Hib 1. Samples were recruited using consecutive sampling technique. There were 69 samples in this study, which were divided into three groups. 1) The group was given a breastfeeding intervention (23 respondents), 2) The second group was given a non Nutritive sucking intervention (23 respondents), and 3) The control group (23 respondents). Data were analyzed using ANOVA.

Results: The pain response of the three groups was groups was 2.74 in breastfeeding group, 1.87 in non-nutritive sucking group, and 3.26 in control group. There was a significant difference between non-nutritive sucking and control group with p-value = 0,000, and also the significant difference between breastfeeding and non-nutritive sucking with p-value = 0.016. However, there was no difference between breastfeeding and control group with p value = 0.142.

Conclusion: Breastfeeding and non-nutritive sucking were effective in reducing pain during infant immunization. It is suggested that midwives could administer these interventions to reduce pain in infant immunization, and it could be applied as non-pharmacological strategy in pain management in the Community Health Center in Indonesia.


breastfeeding, non-nutritive sucking, pain, immunization

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WHO. Children's Environmental Health: Environmental Risks. 2017; http://www.who.int/ceh/risks/en/. Accessed 3 January, 2017.

Hadinegoro SR. Panduan Imunisasi Anak: Mencegah Lebih Baik Daripada Mengobati: Jakarta: Ikatan Dokter Anak Indonesia; 2011.

Penyakit DJP, Lingkungan P, Jawab P, et al. BUKU AJAR IMUNISASI. 2014.

Hockenberry MJ, Wong DL. Wong's clinical manual of pediatric nursing: Mosby Elsevier Health Science; 2003.

Phillips RM, Chantry CJ, Gallagher MP. Analgesic effects of breast-feeding or pacifier use with maternal holding in term infants. Ambulatory Pediatrics. 2005;5(6):359-364.

Hockenberry MJ, Wilson D. Wong's nursing care of infants and children: Elsevier Health Sciences; 2014.

Kashaninia Z, Sajedi F, Rahgozar M, Noghabi FA. The effect of kangaroo care on behavioral responses to pain of an intramuscular injection in neonates. Journal for Specialists in Pediatric Nursing. 2008;13(4):275-280.

Freud S, Bonaparte PM. The origins of psychoanalysis. Vol 216: Imago London; 1954.

McGrath JM. Developmental care of newborns & infants: A guide for health professionals: NANN; 2010.

Gibbins S, Stevens B. Mechanisms of sucrose and non-nutritive sucking in procedural pain management in infants. Pain Research and Management. 2001;6(1):21-28.

Mizrahi T, Sultan S, Charest M-C, et al. Training nurses in basic hypno-analgesia techniques to reduce procedural distress and pain in children: A feasibility trial. Cogent Medicine. 2016;3(1):1165083.

Voepel-Lewis T, Shayevitz JR, Malviya S. The FLACC: a behavioral scale for scoring postoperative pain in young children. Pediatr Nurs. 1997;23:293-297.

Yudiyanta NK, Novitasari RW. Assessment Nyeri. Jurnal CDK. 2015;226.

Sabur RP, Risan NA, Chairulfatah A. Korelasi Skala FLACC dengan Kadar Alfa Amilase Saliva pada Anak Palsi Serebral. Sari Pediatri. 2016;18(2):142-145.

Prasetyono D. Buku Pintar ASI Eksklusif, Pengenalan Praktek dan Kemanfaatannya: Jogyakarta: Diva Press; 2009.

Gray L, Miller LW, Philipp BL, Blass EM. Breastfeeding is analgesic in healthy newborns. Pediatrics. 2002;109(4):590-593.

Liaw J-J, Zeng W-P, Yang L, Yuh Y-S, Yin T, Yang M-H. Nonnutritive sucking and oral sucrose relieve neonatal pain during intramuscular injection of hepatitis vaccine. Journal of pain and symptom management. 2011;42(6):918-930.

Palmer LF. Oxytocin-a Bonding Hormone2002.

Badr LK, Abdallah B, Hawari M, et al. Determinants of premature infant pain responses to heel sticks. Pediatric nursing. 2010;36(3):129.

Chermont AG, Falcão LFM, de Souza Silva EHL, Balda RdCX, Guinsburg R. Skin-to-skin contact and/or oral 25% dextrose for procedural pain relief for term newborn infants. Pediatrics. 2009;124(6):e1101-e1107.


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