Breastfeeding or breast milk for procedural pain in neonates

Cochrane review of 20 RCTs. Direct breastfeeding during heel lance and venipuncture reduces crying time and behavioural pain scores in neonates versus swaddling/positioning controls, and is comparable to oral sucrose. Expressed breast milk alone (without contact) provides less analgesia than the breastfeeding "bundle" (skin-to-skin + sucking + sweet taste + parent voice). Operational endorsement: bring infants to mother for vaccinations when feasible.