Comparison of the analgesic efficacy of expressed breast milk and 25% dextrose during the first hepatitis B vaccination

Abstract

Background: Injectable vaccines are a common source of pain and distress for newborn babies. Sweet-tasting solutions such as
sucrose and 25% dextrose (25D) are described as effective strategies for pain relief in newborns. Objective: This study was done
to compare the analgesic efficacy of expressed breast milk (EBM) and 25D solution during vaccination with hepatitis B (Hep B)
vaccine at birth. Materials and Methods: This study was conducted at the vaccination clinic in the pediatrics department of a
tertiary care hospital in southern India. The participants included healthy term babies and late preterm babies at the clinic during
their routine dose of Hep B at birth, during the study period from June 2017 to December 2017. A total of 70 consecutive neonates
were randomly allocated into two groups. 2 ml of either EBM or 2 ml of 25D solution was given 1 min before the injection. The
outcome variables recorded were the duration of cry after injection and Neonatal Infant Pain Scale (NIPS) scores for both the
groups. Results: The duration of cry was found to be slightly higher in the group receiving EBM than those receiving 25D, although
it was not found to be statistically significant. The neonates in the 25D group had lower NIPS scores than those in the EBM group.
Conclusions: 25D appears to be a slightly better analgesic when compared to EBM during Hep B injection at birth.