A central goal of The Academy of Breastfeeding Medicine is the development of clinical protocols for managing commonmedical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breast-feeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care.Variations in treatment may be appropriate according to the needs of an individual patient. These guidelines are notintended to be all-inclusive, but to provide a basic framework for physician education regarding breastfeeding.

　　Background
　　Newborns and young infantsroutinely experience painassociated with commonly used invasive procedures suchas blood sampling and intramuscular injections (e.g., vaccina-tions, vitamin K) and, in some countries, circumcision (the re-moval of some or all of the foreskin [prepuce] from the penis).1Reductionofpainisbothaprofessionalimperativeandaneth-ical expectation because untreated pain has detrimental conse-quences2such as greater pain sensitivity in later childhood3–6and may lead to permanent neuroanatomical and behavioralabnormalities as demonstrated in animal models.3,7Moreover,pain is a source of concern and distress for new parents andmay disturb mother–infant bonding.8Pain reduction therapiesare often underused for the numerous minor procedures that arepart of routine medical and nursing care for neonates.9,10Grow-ing scientific and clinical evidence from both animal and humannewborns points to the efficacy of natural, non-pharmacologicinterventions to reduce pain due to minor procedures.

　　Purpose
　　The International Evidence-Based Group for Neonatal Painand the American Academy of Pediatrics recommend that allneonatal units develop strategies to minimize the number ofminor painful or stressful procedures and to provide effectivenon-pharmacologic and/or pharmacologic pain relief fornewborns.The purpose of this protocol is to provide health-care professionals with evidence-based guidelines on how toincorporate non-pharmacologic or behavioral interventions torelieve procedure-induced pain in the breastfeeding infant.

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