{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T22:58:29Z","timestamp":1776207509329,"version":"3.50.1"},"reference-count":17,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,6,1]]},"abstract":"\n OBJECTIVES:<\/jats:title>\n Intravenous (IV) and intramuscular (IM) antibiotics have comparable efficacy in treating neonates undergoing sepsis evaluations. There are no clinical data favoring the use of either route regarding newborn pain and parental preferences. We hypothesized that pain associated with IM injections would worsen breastfeeding effectiveness and decrease parental satisfaction, making IV catheters the preferred route.<\/jats:p>\n <\/jats:sec>\n \n METHODS:<\/jats:title>\n This prospective cohort study took place in an academic institution with nurseries in 2 separate hospitals, 1 providing IV antibiotics, and the other, IM antibiotics. Newborns receiving 48 hours of antibiotics were compared by using objective pain and breastfeeding scores and parental surveys.<\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n In 185 newborns studied, pain scores on a 7-point scale were up to 3.4 points higher in the IM compared with the IV group (P &lt; .001). Slopes of repeated pain scores were 0.42 \u00b1 0.08 and \u22120.01 \u00b1 0.11 in the IM and IV groups, respectively (P = .002). Breastfeeding scores were similar between groups. Parents in the IV group were less likely to perceive discomfort with antibiotic administration (odds ratio [OR] 0.22; 95% confidence interval [CI] 0.06\u20130.74) but more likely to perceive interference with breastfeeding (OR 26; 95% CI 6.4\u2013108) and bonding (OR 101; 95% CI 17\u2013590) and more likely to prefer changing to the alternate route (OR 6.9; 95% CI 2.3\u201320).<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS:<\/jats:title>\n IM antibiotics in newborns are associated with pain sensitization and greater pain than IV dosing. Despite accurately recognizing newborn pain with the IM route, parents preferred this to the IV route, which was perceived to interfere with breastfeeding and bonding.<\/jats:p>\n <\/jats:sec>","DOI":"10.1542\/hpeds.2018-0275","type":"journal-article","created":{"date-parts":[[2019,5,31]],"date-time":"2019-05-31T13:25:24Z","timestamp":1559309124000},"page":"464-467","source":"Crossref","is-referenced-by-count":2,"title":["Pain Sensitization, Breastfeeding Effectiveness, and Parental Preferences by Antibiotic Route in Suspected Neonatal Sepsis"],"prefix":"10.1542","volume":"9","author":[{"given":"Lina","family":"Patel","sequence":"first","affiliation":[{"name":"Department of Pediatrics, University of California, Los Angeles Mattel Children\u2019s Hospital, Los Angeles, California; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James A.","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of California, Los Angeles Mattel Children\u2019s Hospital, Los Angeles, California; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rong","family":"Guo","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine and Health Sciences Research, Department of Medicine, University of California, Los Angeles, Los Angeles, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deepa","family":"Kulkarni","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of California, Los Angeles Mattel Children\u2019s Hospital, Los Angeles, California; and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2019,6,1]]},"reference":[{"issue":"RR-10","key":"2021120817084456500_B1","first-page":"1","article-title":"Prevention of perinatal group B streptococcal disease\u2013revised guidelines from CDC, 2010","volume":"59","author":"Verani","year":"2010","journal-title":"MMWR Recomm Rep"},{"issue":"1","key":"2021120817084456500_B2","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1542\/peds.2005-0179","article-title":"Empiric use of ampicillin and cefotaxime, compared with ampicillin and gentamicin, for neonates at risk for sepsis is associated with an increased risk of neonatal death","volume":"117","author":"Clark","year":"2006","journal-title":"Pediatrics"},{"issue":"11","key":"2021120817084456500_B3","doi-asserted-by":"crossref","first-page":"1086","DOI":"10.1001\/archpedi.1985.02140130024022","article-title":"Gentamicin vs cefotaxime for therapy of neonatal sepsis. 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