Abstract
Objective
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.
Design
Randomized, placebo controlled trial.
Setting
Immunization clinic of Department of Pediatrics, LLRM Medical College.
Participants
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.
Results
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.
Conclusions
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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References
Grunau RVE, Graig KD. Pain expression in neonates; facial action and cry. Pain. 1987;28:395–410.
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.
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.
Stevens B, Yamada J, Ohlsson A. Sucrose for analgesia in newborn infants undergoing painful procedures. Cochrane Database Syst Rev. 2010;1:CD001069.
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.
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.
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.
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.
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.
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.
Osinaike BB, Oyedeji AO, Adeoye OT, Dairo MD, Aderinto DA. Effect of breastfeeding during venepuncture in neonates. Ann Trop Paediatr. 2007;27:201–205.
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.
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.
Skogsdal Y, Erricson M, Schollin. Analgesia in newborns given oral glucose. Acta Pediatr. 1997;86:217–220.
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.
Gonsolves S, Mercer J. Physiological correlates of painful stimulation in preterm infants. Clin J Pain. 1993;9:88–93.
Gray L, Watt L, Blass EM. Skin-to-skin contact is analgesic in healthy newborns. Pediatrics. 2000;105:252–257.
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.
Efe E, Ozer ZC. The use of breast-feeding for pain relief during neonatal immunization injections. Appl Nurs Res. 2007;20:10–16.
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.
Gray L, Miller LW, Philipp BL, Blass EM. Breastfeeding is analgesic in healthy newborns. Pediatrics. 2002;109:590–593.
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.
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.
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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). https://doi.org/10.1007/s13312-013-0196-8
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DOI: https://doi.org/10.1007/s13312-013-0196-8