Breastfeeding and milk odor reduce pain scores and crying duration in term and preterm infants

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Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine Published June 6, 2026 Medically reviewed June 6, 2026 Study authors: Gök Çiğdem, Karataş Pelin PubMed ↗ DOI ↗ By Dr. Sofia Müller, MD · Lifespan & Whole-Person Care

Key Takeaway

Consider integrating breastfeeding or milk sensory exposure as first-line approaches in neonatal pain management protocols.

This umbrella review and meta-analytic reanalysis examines the role of breastfeeding, breast milk odor, and breast milk taste in managing pain for term and preterm infants within neonatal care settings. The scope covers various populations, procedures, intervention timings, and outcome measures across multiple studies. No specific sample size or follow-up duration was reported. Safety data regarding adverse events, serious adverse events, discontinuations, or tolerability were not reported.

The analysis found large reductions in pain scores, crying duration, and heart rate. Behavioral and physiological pain indicators were also reduced. However, the effect size for these indicators was smaller compared with direct breastfeeding. The review did not report specific p-values or confidence intervals for these outcomes.

The authors highlight substantial heterogeneity across meta-analyses due to variation in populations, procedures, intervention timing, and outcome measures. Non-Cochrane reviews showed moderate-to-low methodological confidence due to limitations such as lack of protocol registration or incomplete reporting. Funding or conflicts of interest were not reported.

The practice relevance supports the integration of breastfeeding or maternal milk sensory exposure as first-line approaches in neonatal pain management protocols. Clinicians should interpret these findings with caution given the methodological limitations and heterogeneity noted by the authors.

Study Details

Study typeMeta analysis

EvidenceLevel 1

PublishedJun 2026

PMID42130203

View Original Abstract ↓

BACKGROUND: Painful procedures are frequently performed in neonatal care, yet their repeated exposure is associated with adverse short- and long-term neurodevelopmental outcomes. Nonpharmacological, physiological, and parent-involved interventions such as breastfeeding and breast milk sensory stimuli have emerged as promising strategies for procedural pain management. OBJECTIVE: This umbrella review and meta-analytic reanalysis aimed to synthesize the evidence from systematic reviews and meta-analyses evaluating the analgesic effects of breastfeeding, breast milk odor, and breast milk taste during painful procedures in term and preterm infants. METHODS: A comprehensive umbrella review approach was applied, and the methodological quality of all included reviews was assessed using the Assessment of Multiple Systematic Reviews-2 tool. Effect sizes from existing meta-analyses were reanalyzed using random-effects models, incorporating heterogeneity, prediction intervals, and clinical variation across interventions and populations. RESULTS: Breastfeeding demonstrated the strongest analgesic effect, with large reductions in pain scores, crying duration, and heart rate during procedural pain. Breast milk odor and taste also reduced behavioral and physiological pain indicators, particularly among preterm infants, though with smaller effect sizes compared with direct breastfeeding. Despite generally consistent effect directions, substantial heterogeneity was observed across meta-analyses due to variation in populations, procedures, intervention timing, and outcome measures. High-quality Cochrane reviews contributed the strongest evidence base, while non-Cochrane reviews showed moderate-to-low methodological confidence due to limitations such as lack of protocol registration or incomplete reporting. CONCLUSIONS: Breastfeeding and breast milk-related sensory interventions are effective, feasible, and safe nonpharmacological strategies for managing procedural pain in neonates. These findings support the integration of breastfeeding or maternal milk sensory exposure as first-line approaches in neonatal pain management protocols. Further research is needed to clarify optimal timing, dosing, and combinations with other nonpharmacological interventions.