{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:14:33Z","timestamp":1787019273356,"version":"build-2736575974"},"reference-count":29,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Breastfeeding Medicine"],"published-print":{"date-parts":[[2026,6,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Breastfeeding and breast milk\u2013related 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15568253261446229","type":"journal-article","created":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T06:23:42Z","timestamp":1778739822000},"page":"326-335","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["The Effects of Breastfeeding and the Taste and Smell of Breast Milk on Pain Reduction in Infants: An Umbrella Review and Reanalysis of Meta-Analytic Evidence"],"prefix":"10.1177","volume":"21","author":[{"given":"\u00c7i\u011fdem","family":"G\u00f6k","sequence":"first","affiliation":[{"name":"Department of Pediatric Nursing, Faculty of Health Science, Pamukkale University, Denizli, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pelin","family":"Karata\u015f","sequence":"additional","affiliation":[{"name":"Department of Pediatric Nursing, Faculty of Nursing, Adnan Menderes University, Ayd\u0131n, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,5,13]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cnc.2018.07.013"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/pr.2014.16"},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000040552"},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2025.106816"},{"key":"e_1_3_2_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.300.1.60"},{"key":"e_1_3_2_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pedneo.2013.04.004"},{"key":"e_1_3_2_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clp.2011.12.013"},{"key":"e_1_3_2_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.iccn.2020.102904"},{"key":"e_1_3_2_10_1","volume-title":"Transformative Nursing in the NICU: Trauma-Informed, Age-Appropriate Care","author":"Coughlin ME","year":"2021","unstructured":"9.Coughlin ME. Transformative Nursing in the NICU: Trauma-Informed, Age-Appropriate Care. Springer Publishing Company: New York; 2021."},{"key":"e_1_3_2_11_1","doi-asserted-by":"publisher","DOI":"10.1089\/bfm.2020.0222"},{"key":"e_1_3_2_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-540-29805-2_2205"},{"key":"e_1_3_2_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.siny.2019.05.009"},{"key":"e_1_3_2_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.siny.2019.04.005"},{"key":"e_1_3_2_15_1","doi-asserted-by":"publisher","DOI":"10.1089\/bfm.2022.0134"},{"key":"e_1_3_2_16_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.081086"},{"key":"e_1_3_2_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/XEB.0000000000000055"},{"key":"e_1_3_2_18_1","doi-asserted-by":"publisher","DOI":"10.1089\/bfm.2017.0226"},{"issue":"8","key":"e_1_3_2_19_1","first-page":"CD004950","article-title":"Breastfeeding or breast milk for procedural pain in neonates","volume":"8","author":"Shah PS","year":"2023","unstructured":"18.Shah PS, , Torgalkar R, , Shah VS. Breastfeeding or breast milk for procedural pain in neonates. Cochrane Database Syst Rev. 2023;8(8):CD004950.","journal-title":"Cochrane Database Syst Rev."},{"issue":"10","key":"e_1_3_2_20_1","first-page":"CD011289","article-title":"Breastfeeding for procedural pain in infants beyond the neonatal period","volume":"2016","author":"Harrison D","year":"2016","unstructured":"19.Harrison D, , Reszel J, , Bueno M, et al. Breastfeeding for procedural pain in infants beyond the neonatal period. Cochrane Database Syst Rev 2016;2016(10):CD011289.","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_2_21_1","doi-asserted-by":"publisher","DOI":"10.1089\/bfm.2023.0233"},{"key":"e_1_3_2_22_1","first-page":"1","article-title":"The analgesic effects of human milk odor in preterm neonates: A systematic review and meta-analysis","author":"Bertol AB","year":"2025","unstructured":"21.Bertol AB, , Vijendra B, , Aquino Gil de Freitas PH, et al. The analgesic effects of human milk odor in preterm neonates: A systematic review and meta-analysis. J Perinatol. 2025:1\u20137.","journal-title":"J Perinatol."},{"key":"e_1_3_2_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12887-025-05504-z"},{"issue":"12","key":"e_1_3_2_24_1","first-page":"CD004950","article-title":"Breastfeeding or breast milk for procedural pain in neonates","volume":"1","author":"Shah PS","year":"2012","unstructured":"23.Shah PS, , Herbozo C, , Aliwalas LL, et al. Breastfeeding or breast milk for procedural pain in neonates. Cochrane Database Syst Rev. 2012;1(12):CD004950.","journal-title":"Cochrane Database Syst Rev."},{"key":"e_1_3_2_25_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0001350"},{"key":"e_1_3_2_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2008.10.009"},{"key":"e_1_3_2_27_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-14-25"},{"key":"e_1_3_2_28_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d549"},{"key":"e_1_3_2_29_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"},{"key":"e_1_3_2_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/9780470712184"}],"container-title":["Breastfeeding Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15568253261446229","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15568253261446229","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15568253261446229","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T21:46:26Z","timestamp":1780609586000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15568253261446229"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,13]]},"references-count":29,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6,1]]}},"alternative-id":["10.1177\/15568253261446229"],"URL":"https:\/\/doi.org\/10.1177\/15568253261446229","relation":{},"ISSN":["1556-8253","1556-8342"],"issn-type":[{"value":"1556-8253","type":"print"},{"value":"1556-8342","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,13]]}}}