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Comparison of analgesic effect of direct breastfeeding, oral 25% dextrose solution and placebo during 1st DPT vaccination in healthy term infants: A randomized, placebo controlled trial



To compare analgesic effect of direct breast feeding, 25% dextrose solution and placebo as we give 1st intramuscular whole cell DPT injection to 6week — 3month old infants.


Randomized, placebo controlled trial.


Immunization clinic of Department of Pediatrics, LLRM Medical College.


Infants coming for their 1st DPT vaccination were randomized in to three groups of 40 each.

Outcome measures

The primary outcome variable was the duration of cry after vaccination. Secondary outcome variables were Modified Facial Coding Score (MFCS) and latency of onset of cry.


120 babies were equally enrolled in breast feed group, 25% dextrose fed group and distilled water fed group. Median (interquartile range) of duration of cry was significantly lower in breast fed (33.5 (17–54) seconds) and 25% dextrose fed babies (47.5 (31–67.5) seconds) as compared to babies given distilled water (80.5 (33.5–119.5) seconds) (P<0.001). MFCS at 1 min and 3 min was significantly lower in direct breast fed and dextrose fed babies.


Direct breastfeeding and 25% dextrose act as analgesic in young infants undergoing DPT vaccination in young infants less than 3 month of age.

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  1. Grunau RVE, Graig KD. Pain expression in neonates; facial action and cry. Pain. 1987;28:395–410.

    PubMed  Article  CAS  Google Scholar 

  2. Barr RG. Reflections on measuring pain in infants: Dissociation in responsive systems and “honest signaling”. Arch Dis Child Fetal Neonatal Ed. 1998;79:F152–F156.

    PubMed  Article  CAS  Google Scholar 

  3. Anand KJ. International Evidence-Based Group for Neonatal Pain. Consensus statement for the prevention and management of pain in the newborn. Arch Pediatr Adolesc Med. 2001;155:173–180.

    PubMed  Article  CAS  Google Scholar 

  4. Stevens B, Yamada J, Ohlsson A. Sucrose for analgesia in newborn infants undergoing painful procedures. Cochrane Database Syst Rev. 2010;1:CD001069.

    PubMed  Google Scholar 

  5. Carbajal R, Chauvet X, Couderc S, Olivier-Martin M. Randomised trial of analgesic effects of sucrose, glucose, and pacifiers in term neonates. BMJ. 1999;319:1393–1397.

    PubMed  Article  CAS  Google Scholar 

  6. Bucher HU, Baumgartner R, Bucher N, Seiler M, Fauchère JC. Artificial sweetener reduces nociceptive reaction in term newborn infants. Early Hum Dev. 2000;59:51–60.

    PubMed  Article  CAS  Google Scholar 

  7. Harrison D, Stevens B, Bueno M, Yamada J, Adams-Webber T, Beyene J, et al. Efficacy of sweet solutions for analgesia in infants between 1 and 12 months of age: a systematic review. Arch Dis Child Fetal Neonatal Ed. 2010;95:406–413.

    Google Scholar 

  8. Stevens B, Taddio A, Ohlsson A, Einarson T. The efficacy of sucrose for relieving procedural pain neonates-a systemstic review and metaanalysis. Acta Pediatr. 1997;86:837–842.

    Article  CAS  Google Scholar 

  9. Upadhyay A, Aggarwal R, Narayan S, Joshi M, Paul VK, Deorari AK. Analgesic effect of expressed breast milk in procedural pain in term neonates: a randomized, placebocontrolled, double-blind trial. Acta Paediatr. 2004;93:518–522.

    PubMed  Article  CAS  Google Scholar 

  10. Uyan ZS, Ozek E, Bilgen H, Cebeci D, Akman I. Effect of foremilk and hindmilk on simple procedural pain in newborns. Pediatr Int. 2005;47:252–257.

    PubMed  Article  Google Scholar 

  11. Osinaike BB, Oyedeji AO, Adeoye OT, Dairo MD, Aderinto DA. Effect of breastfeeding during venepuncture in neonates. Ann Trop Paediatr. 2007;27:201–205.

    PubMed  Article  CAS  Google Scholar 

  12. Singh VB, Mishra SK, Singh T, Upadhyay A. Antinociceptive effect of exclusive breastfeeding in healthy term infants during vaccination. Early Human Development. 2008;84:50–51.

    Google Scholar 

  13. Uga E, Candriella M, Perino A, Alloni V, Angilella G, Trada M, et al. Heel lance in newborn during breastfeeding: an evaluation of analgesic effect of this procedure. Ital J Pediatr. 2008;34:3.

    PubMed  Article  Google Scholar 

  14. Skogsdal Y, Erricson M, Schollin. Analgesia in newborns given oral glucose. Acta Pediatr. 1997;86:217–220.

    Article  CAS  Google Scholar 

  15. Ramenghi LA, Wood CM, Griffith GC, Levene MI. Reduction of pain response in premature infants using intraoral sucrose. Arch Dis Child Fetal Neonatal Ed. 1996;74:F126–F128.

    PubMed  Article  CAS  Google Scholar 

  16. Gonsolves S, Mercer J. Physiological correlates of painful stimulation in preterm infants. Clin J Pain. 1993;9:88–93.

    Article  Google Scholar 

  17. Gray L, Watt L, Blass EM. Skin-to-skin contact is analgesic in healthy newborns. Pediatrics. 2000;105:252–257.

    Article  Google Scholar 

  18. Okan F, Ozdil A, Bulbul A, Yapici Z, Nuhoglu A. Analgesic effects of skin-to-skin contact and breastfeeding in procedural pain in healthy term neonates. Ann Trop Paediatr. 2010;30:119–128.

    PubMed  Article  CAS  Google Scholar 

  19. Efe E, Ozer ZC. The use of breast-feeding for pain relief during neonatal immunization injections. Appl Nurs Res. 2007;20:10–16.

    PubMed  Article  Google Scholar 

  20. Phillips RM, Chantry CJ, Gallagher MP. Analgesic effects of breast-feeding or pacifier use with maternal holding in term infants. Ambul Pediatr. 2005;5:359–364.

    PubMed  Article  Google Scholar 

  21. Gray L, Miller LW, Philipp BL, Blass EM. Breastfeeding is analgesic in healthy newborns. Pediatrics. 2002;109:590–593.

    PubMed  Article  Google Scholar 

  22. Codipietro L, Ceccarelli M, Ponzone A. Breastfeeding or oral sucrose solution in term neonates receiving heel lance: A randomized, controlled trial. Pediatrics. 2008;122:716–721.

    Article  Google Scholar 

  23. Shah PS, Aliwalas L, Shah V. Breastfeeding or breast milk to alleviate procedural pain in neonates: a systematic review. Breastfeed Med. 2007;2:74–82.

    PubMed  Article  Google Scholar 

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Correspondence to Amit Upadhyay.

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Goswami, G., Upadhyay, A., Gupta, N.K. et al. Comparison of analgesic effect of direct breastfeeding, oral 25% dextrose solution and placebo during 1st DPT vaccination in healthy term infants: A randomized, placebo controlled trial . Indian Pediatr 50, 649–653 (2013).

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  • 25% dextrose
  • Breastfeeding
  • Duration of cry
  • DPT vaccination
  • Management
  • Pain
  • Infant