Comparison of vaccination-related pain in infants who receive vapocoolant spray and breastfeeding during injection

BACKGROUND: Vaccination is one of the most common painful procedures in infants. Despite the irreparable consequences and complications of acute pain in infants, and existence of pharmacological and non-pharmacological methods for pain control, pain control in infants has received less attention. Therefore, this research aimed to compare the vaccination-related pain in infants younger than 6 months who receive vapocoolant spray and breastfeeding during injection, in order to suggest a strategy to provide emotional, mental, and physical health for infants. MATERIALS AND METHODS: This is a randomized clinical trial study on 144 infants less than 6 months of age, referred to Ibn Sina Health Care Center in 2009, who were selected by convenience sampling. Forty-eight infants were allocated through systematic random sampling to each study group (i.e., breastfeeding, vapocoolant spray, and control group). Inclusion criteria were: Fully conscious infants, lack of any disease (sensory, motor abnormalities, cold, etc.), taking no medication, exclusive breastfeeding, vaccination for hepatitis B and DTP, regular visits to health care center, infants with Iranian nationality, and quiet infants who did not cry. The infant was excluded if he/she was crying and it was impossible to make him/her quiet before injection. Data were gathered by a questionnaire (six questions) and checklist [neonatal infant pain scale (NIPS)]. Data were analyzed by descriptive and inferential statistical methods through SPSS. RESULTS: The findings suggest that breastfeeding during vaccination has a more analgesic effect on vaccination pain, compared to application of vapocoolant spray before vaccination. In 64.6% of the infants, breastfeeding during vaccination caused analgesia, while 25% of the infants who received vapocoolant spray experienced analgesic effect. There was a significant difference in pain between the infants who received vapocoolant spray and those on breastfeeding during injection (P < 0.001). CONCLUSION: It seems that breastfeeding during vaccination in infants under 6 months of age is an effective, natural, safe, accessible, and inexpensive method without side effects to reduce vaccination-related pain.