Sweet-tasting Solutions Research Articles

Pain in Neonates: Perceptions and Current Practices.

All newborns experience pain during routine care, which can have long-lasting negative effects. Despite the availability of effective methods to prevent and reduce pain, most infants will receive ineffective or no treatment. Optimal pain management includes the reduction of the number of procedures performed, routine pain assessment and the use of effective pain-reducing interventions, most notably breastfeeding, skin-to-skin contact and sweet-tasting solutions. Parents are an essential component of the comprehensive assessment and management of infant pain; however, a gap exists regarding the uptake of parent-led interventions and the engagement of families. Practice recommendations for infant pain care are discussed.

Evaluation of the efficacy of sweet-tasting solution in reducing the discomfort and unpleasantness experienced while taking radiographs in children between 8-12 years old.

Evaluation of the efficacy of sweet-tasting solution in reducing the discomfort and unpleasantness experienced while taking radiographs in children between 8-12 years old.

Effect of cryoanesthesia and sweet tasting solution in reducing injection pain in pediatric patients aged 7-10 years: a randomized controlled trial.

The delivery of profound local anesthetics helps children receive successful treatment by reducing fear, anxiety, and discomfort during dental procedures. Local anesthetic injections are the most anticipated stimuli in dental surgery. Children's perceptions of pain can be altered by applying cryotherapy to precool the oral mucosa or by diverting their minds through taste distractions before administering local anesthetic injections. This study aimed to evaluate the efficacy of cryoanesthesia and xylitol sweet-tasting solution at the injection site in 7-10-year-old children. A total of 42 participants, aged 7-10 years, who underwent dental treatment requiring local anesthesia, were enrolled in the study. The children were randomly divided into three groups. In group I, sterile water was held in the mouth for 2 minutes before anesthetic administration, similar to group II, and in group III, a xylitol sweet-tasting solution was used for 2 minutes before needle insertion. The analysis of pain perception was carried out based on the Visual Analog Scale (VAS) and the Sound, Eyes, and Motor (SEM) scale. For VAS analysis, a one-way analysis of variance (ANOVA) was performed for intergroup comparison, and a post hoc Tukey test was performed for subgroup analysis. For the categorical SEM scale, the Kruskal-Wallis test followed by the post hoc test was performed for intergroup comparison. Where a P value of <0.05 was considered statistically significant at 95% confidence intervals. Cryoanesthesia significantly reduced pain scores on VAS (4.21 ± 1.42) when compared to those on VAS with xylitol sweet-tasting solution (5.50 ± 1.40) and that with sterile water (6.14 ± 2.47). Intergroup comparison of the VAS scores among the three groups was performed using one-way ANOVA, which demonstrated statistically significant differences (P value <0.026) on the VAS scale. Intergroup comparison of the SEM scale was performed using the Kruskal-Wallis test, followed by post hoc comparison, which exhibited statistically significant differences (P < 0.007) among the three groups for the SEM scale. Cryoanesthesia demonstrated higher efficacy in reducing injection pain than that exhibited by the xylitol sweet-tasting solution.

Efficacy of sucrose application in minimizing pain perception related to dental injection in children aged 3 to 9 years: a randomized control trial.

Dental fear and anxiety are significant challenges in managing behavior in children. Oral administration of sucrose or sweet-tasting solutions has shown effectiveness in reducing procedural pain in infants and neonates. This study aimed to investigate whether pre-application of sucrose solution had an effect on minimizing pain perception during injection and to assess the potential impact of the child's age and sweet preference. A randomized control clinical trial was conducted on 60 children aged 3-9 years requiring buccal infiltration injections. Following parental consent, demographic data of the children were recorded. Sweet preferences was assessed using a modified forced-choice test. Children were equally and randomly allocated into study (sucrose) and control groups using a lottery method. Sucrose solution or distilled water, respectively, was applied to the lateral surface of the tongue for 2 min. Topical anesthetic was applied at the site of injection, followed by local anesthesia administration. The children rinsed their mouths thrice with water immediately after anesthetic injection. A video was recorded during injection which was then scored by three blinded examiners on the Sound Eye Motor (SEM) scale. The children also self-evaluated using Wong-Baker Faces Pain Rating Scale (WBFPS). The mean SEM scores and WBFPS scores were analyzed using the Kruskall-Wallis test. The mean SEM score in the study group was 1.37 ± 0.61, compared to 3.17 ± 0.87 in the control group, showing a statistically significant difference (P < 0.001). Mean pain scores assessed by WBFPS in the study group were 0.60 ± 1.4, while in the control group, they were 6.27 ± 2.33, also showing a statistically significant difference (P < 0.001). Children with a sweet preference demonstrated a subjective reduction in pain perception. Application of sucrose before dental injections in children helps to minimize pain upon injection across all age groups.

Intensity and Appreciation of Sweet Taste Solutions Are Modulated by High-Intensity Aerobic Exercise in Adolescent Athletic Males.

Exercise seems to influence taste, but the effect of exercise on specific tastes is still to be elucidated among youths. Athlete boys aged 14-16years were recruited. Participants (n = 19) ages ranged 14.7 (0.7)years, weight 59.6 (7.8)kg, and height of 173.4 (7.9)cm. Distinct taste tests were administered using low and high concentrations of sweet, salty, and bitter solutions before and after a 30-minute aerobic exercise session (70%-90% of estimated maximal heart rate). McNemmar tests, standard paired t tests, Wilcoxon signed-rank tests, and Cohen d effect size tests were used to analyze taste identification, intensity, and appreciation. There were no significant differences in taste identification capacities after exercise. Participants perceived more intense (P = .037) and appreciated better (P = .004) the low-concentration sweet solution after exercise. Taste appreciation was increased for the high-concentration sweet solution (P = .009) after exercise. Effect sizes were moderate (0.516-0.776). Possible effects were noted for the intensity of salty solutions (P = .0501 and .0543). Following an exercise session, participants had increased perceived intensity and appreciation of sweet solutions. This adds new insights into how exercise influences taste in youths, a topic less documented compared with adults, suggesting further research into its impact on dietary choices is needed.

Chronic sugar exposure increases daily intake of sugars but decreases avidity for sweeteners in mice

Little is known about how chronic sugar consumption impacts avidity for and daily intake of sugars. This issue is topical because modern humans exhibit high daily intakes of sugar. Here, we exposed sugar-naïve C57BL/6 mice (across two 28-day exposure periods, EP1 and EP2) to a control (chow and water) or experimental (chow, water and a 11 or 34% sugar solution) diet. The sugar solutions contained sucrose, glucose syrups, or high-fructose syrups. We used brief-access tests to measure appetitive responses to sucralose and sucrose solutions at three time points: baseline (before EP1), after EP1, and after EP2. We used lick rates to infer palatability, and number of trials initiated/test to infer motivation. Exposure to the control diet had no impact on lick rates or number of trials initiated for sucralose and sucrose. In contrast, exposure to the experimental diets reduced licking for the sweeteners to varying degrees. Lick rates were reduced by exposure to sugar solutions containing the 11% glucose syrups, 34% sucrose, 34% glucose syrups and 34% high-fructose syrups. The number of trials initiated was reduced by exposure to all of the sugar solutions. Despite the exposure-induced reductions in avidity for the sweetener solutions, daily intakes of virtually all of the sugar solutions increased across the exposure periods. We conclude that (i) chronic consumption of sugar solutions reduced avidity for the sweetened solutions, (ii) the extent of this effect depended on the concentration and type of sugar, and (iii) avidity for sweet-tasting solutions could not explain the persistently high daily intake of sugar solutions in mice.

Evaluation of the effectiveness of sucrose versus xylitol application in minimizing pain related to dental injection in 5-7-year-old children - A randomized controlled pilot study.

Oral application of sweet-tasting solutions has found to be effective in minimizing pain on dental injection in children. Xylitol has never been tested in this regard. The aim of this study was to compare the effectiveness of prior application of sucrose versus xylitol solution in minimizing pain on dental injection in 5-7-year-old children. This study was a randomized controlled clinical trial. Informed consent was taken. A total of 30 children who required maxillary buccal infiltration injection were selected. The children were randomly allocated into the sucrose group, xylitol group, or control group by lottery method. In the sucrose and xylitol groups, 30% sucrose or 30% xylitol solution was applied on the lateral surface of the tongue for 2 min. In the control group, distilled water was applied. In all the groups, the topical anesthetic was applied at the site of injection followed by buccal infiltration. A video was taken during injection, and the sound eye-motor (SEM) scale was recorded by a blinded examiner. Patients were asked to self-evaluate using the Wong-Baker Faces Pain Scale (WBFPS). Mann-Whitney test was used to analyze the data. There was a statistically significant difference in the WBFPS and the SEM score between the sucrose and the control group (P < 0.05) and the xylitol and control group (P < 0.05). No statistically significant difference was found between the sucrose and xylitol group. The application of xylitol solution before dental injection was as effective as sucrose solution in minimizing pain during the injection.

Chemogenetic inhibition of the bed nucleus of the stria terminalis suppresses the intake of a preferable and learned aversive sweet taste solution in male mice

Conditioned taste aversion (CTA) is established by pairing a taste solution as a conditioned stimulus (CS) with visceral malaise as an unconditioned stimulus (US). CTA decreases the taste palatability of a CS. The bed nucleus of the stria terminalis (BNST) receives taste inputs from the brainstem. However, the involvement of the BNST in CTA remains unclear. Thus, this study examined the effects of chemogenetic inhibition of the BNST neurons on CS intake after CTA acquisition. An adeno-associated virus was microinjected into the BNST of male C57/BL6 mice to induce the inhibitory designer receptor hM4Di. The mice received a pairing of 0.2% saccharin solution (CS) with 0.3 M lithium chloride (2% BW, intraperitoneal). After conditioning, the administration of clozapine–N–oxide (CNO, 1 mg/kg) significantly enhanced the suppression of CS intake on the retrieval of CTA compared with its intake following saline administration (p < 0.01). We further assessed the effect of BNST neuron inhibition on the intake of water and taste solutions (saccharin, sucralose, sodium chloride, monosodium glutamate, quinine hydrochloride, and citric acid) using naïve (not learned CTA) mice. CNO administration significantly decreased the intake of saccharin and sucralose (p < 0.05). Our results indicate that BNST neurons mediate sweet taste and regulate sweet intake, regardless of whether sweets should be ingested or rejected. BNST neurons may be inhibited in the retrieval of CTA, thereby suppressing CS intake.

Effectiveness of Pre-administered Natural Sweet-tasting Solution for Decreasing Pain Associated with Dental Injections in Children: A Split-mouth Randomized Controlled Trial

This study aimed to discern if a prior intake of a natural sweet remedy (honey) impacted pain perception during intraoral injections. One hundred healthy children who needed the same treatment bilaterally in either arch which required local anesthetic administration (infiltration in maxillary arch and inferior alveolar nerve block in mandibular arch) were recruited. The patients' demographic details were recorded. Local anesthesia was administered after taking 5 mL of honey solution on the test side and 5 mL of sterile water on the control side. Subjective pain perception during injection was measured using Wong-Baker Faces Pain Rating Scale and objective pain by sound, eye, body movement (SEM) rating scale. The parametric data were analyzed using a paired Student's t-test (p <0.05). Level of consensus between the two scales was assessed using Pearson's correlation. The test side yielded lower mean Wong-Baker Faces Pain Rating Scale (3.72 ± 1.80) and SEM (4.12 ± 1.04) scores than the control side (6.00 ± 2.06 and 5.00 ± 1.45 respectively). This was statistically significant. The administering of a natural sweet solution such as honey before dental injections in children tends to reduce the discomfort and pain associated with the procedure. Pain management is of utmost importance in dentistry, especially among children. The consumption of natural foods such as honey helps in decreasing injection pain perception, making the child cooperative, and thereby allowing the dentist to provide the best dental care.

Supplementation effects of a kokumi substance, γ-Glu-Val-Gly, on the ingestion of basic taste solutions in rats

In addition to the well-accepted taste receptors corresponding to the 6 basic taste qualities, sweet, salty, sour, bitter, umami, and fatty, another type of taste receptor, calcium-sensing receptor (CaSR), is located in taste bud cells. CaSR is called the kokumi receptor because its agonists induce koku (or kokumi), a Japanese word meaning the enhancement of flavor characteristics, such as thickness, mouthfulness, and continuity. Kokumi is an important factor in enhancing food palatability. γ-Glu-Val-Gly (EVG) is the most potent agonist of CaSR, which induces a strong kokumi flavor. However, no behavioral studies have been documented in animals using EVG. Here, we show that EVG at low concentrations that do not elicit a taste of its own enhances preferences for umami, fat, and sweet taste solutions in rats. An increased preference for inosine monophosphate (IMP) and Intralipos was the most dominant effect. NPS-2143, an antagonist of CaSR, abolished the additive effect of EVG on IMP and Intralipos solutions. These effects of EVG on taste stimuli are thought to occur in the oral cavity, because the effects of EVG were confirmed in a brief exposure test. The additive effects on IMP and Intralipos remained after the transection of the chorda tympani, indicating that these effects also occur in the palate and/or posterior part of the tongue. Moreover, the additive effects of EVG were verified in electrophysiological taste nerve responses. These results may partially provide the underlying mechanisms for EVG to induce kokumi flavor in humans.

Chemogenetic Inhibition of the Bed Nucleus of the Stria Terminalis Suppresses the Intake of a Preferable and Learned Aversive Sweet Taste Solution in Male Mice

Chemogenetic Inhibition of the Bed Nucleus of the Stria Terminalis Suppresses the Intake of a Preferable and Learned Aversive Sweet Taste Solution in Male Mice

Be Sweet to Hospitalized Toddlers During Venipuncture: A Randomized Controlled Trial of Sucrose Compared With Water.

High-quality evidence demonstrates analgesic effects of sweet-tasting solutions for infants during painful procedures. However, evidence of the analgesic effects of sucrose beyond 12 months of age is less certain. The aim of this study was to ascertain the efficacy of oral sucrose in hospitalized toddlers (ages 12 to 36 mo) compared with placebo (water) during venipuncture. Blinded, 2-armed randomized controlled trial including hospitalized toddlers aged 12 to 36 months. Toddlers were randomized to either 25% sucrose or water before venipuncture, stratified by age (12 to 24 mo and more than 24 to 36 mo). Standard of care included topical anesthetics for both groups. Pain assessment included cry duration and FLACC (Face, Legs, Activity, Cry, Consolability) scores. Descriptive statistics and linear models were used to report the percentage of time crying and mean differences in FLACC scores. Data analysis was performed using R, version 3.6.3. A total of 95 toddlers were randomized and 85 subsequently studied. The median percentage of time spent crying between insertion of the first needle and 30 seconds after the end of procedure in both groups was 81% (interquartile range=66%). There was no significant difference in crying time and FLACC scores between groups (P>0.05). When examining effects of sucrose for the younger toddlers (less than 24 mo of age) there was a reduction in crying time of 10% and a 1.2-point reduction in mean FLACC scores compared with the toddlers older than 24 months. Findings highlight that toddlers become highly distressed during venipuncture, despite the standard care of topical anesthetics. In addition, sucrose does not effectively reduce distress especially in the older group of toddlers.

Additive Effects of L-Ornithine on Preferences to Basic Taste Solutions in Mice.

In addition to the taste receptors corresponding to the six basic taste qualities—sweet, salty, sour, bitter, umami, and fatty—another type of taste receptor, calcium-sensing receptor (CaSR), is found in taste-bud cells. CaSR is called the ‘kokumi’ receptor because its agonists increase sweet, salty and umami tastes to induce ‘koku’, a Japanese word meaning the enhancement of flavor characters such as thickness, mouthfulness, and continuity. Koku is an important factor for enhancing food palatability. However, it is not well known whether other kokumi-receptors and substances exist. Here, we show that ornithine (L-ornithine but not D-ornithine) at low concentrations that do not elicit a taste of its own, enhances preferences to sweet, salty, umami, and fat taste solutions in mice. Increased preference to monosodium glutamate (MSG) was the most dominant effect. Antagonists of G-protein-coupled receptor family C group 6 subtype A (GPRC6A) abolished the additive effect of ornithine on MSG solutions. The additive effects of ornithine on taste stimuli are thought to occur in the oral cavity, and are not considered post-oral events because ornithine’s effects were confirmed in a brief-exposure test. Moreover, the additive effects of ornithine and the action of the antagonist were verified in electrophysiological taste nerve responses. Immunohistochemical analysis implied that GPRC6A was expressed in subsets of type II and type III taste cells of mouse circumvallate papillae. These results are in good agreement with those reported for taste modulation involving CaSR and its agonists. The present study suggests that ornithine is a kokumi substance and GPRC6A is a newly identified kokumi receptor.

Evaluation of Neem (Azadirachta indica) Leaf Powder for Assessing Gustatory Function and Comparison with Other Tastants

Aims: Azadirachta indica (meliacea), popularly known as neem has extreme bitter taste however it has high medicinal properties. The study aimed to use the bitterness property of neem leaf powder to assess the bitter taste along with other tastants and to check reliability of this newly introduced method.&#x0D; Materials and methods: 60 healthy subjects were recruited in the present study. Bitter, sweet, salt, sour and umami taste solutions are prepared in three different concentrations. Gustatory recognition threshold was recorded against each concentration of five tastants solutions.&#x0D; Results: A significant difference in the first concentration (.003) of neem between all age groups (p=0.026) but no significant difference in the second and third concentrations were observed. Males have higher gustatory recognition threshold in almost all levels of taste parameters. However, medium and higher concentrations of neem have no significant gender wise difference. An acceptable level of reliability was found in the test retest method conducted in a two week interval.&#x0D; Conclusion: The neem leaf powder solution can be used for bitter taste assessment, is reliable, and can be safely used in the clinical setting.

Quinine Ingestion During the Latter Stages of a 3,000-m Time Trial Fails to Improve Cycling Performance

The ingestion of quinine, a bitter tastant, improves short-term (30 s) cycling performance, but it is unclear whether this effect can be integrated into the last effort of a longer race. The purpose of this study was to determine whether midtrial quinine ingestion improves 3,000-m cycling time-trial (TT) performance. Following three familiarization TTs, 12 well-trained male cyclists (mean ± SD: mass = 76.6 ± 9.2kg, maximal aerobic power = 390 ± 50W, maximal oxygen uptake = 4.7 ± 0.6L/min) performed four experimental 3,000-m TTs on consecutive days. This double-blind, crossover design study had four randomized and counterbalanced conditions: (a)Quinine 1 (25-ml solution, 2mM of quinine); (b)Quinine 2, replicate of Quinine 1; (c)a 25-ml sweet-tasting no-carbohydrate solution (Placebo); and (d)25ml of water (Control) consumed at the 1,850-m point of the TT. The participants completed a series of perceptual scales at the start and completion of all TTs, and the power output was monitored continuously throughout all trials. The power output for the last 1,000m for all four conditions was similar: mean ± SD: Quinine 1 = 360 ± 63W, Quinine 2 = 367 ± 63W, Placebo = 364 ± 64W, and Control = 367 ± 58W. There were also no differences in the 3,000-m TT power output between conditions. The small perceptual differences between trials at specific 150-m splits were not explained by quinine intake. Ingesting 2mM of quinine during the last stage of a 3,000-m TT did not improve cycling performance.

The efficacy of administrating a sweet-tasting solution for reducing the pain related to dental injections in children: A randomized controlled trial.

Anaesthetic injections are an unpleasant experience for children in the dental office. Oral intake of sweet substances by newborns has been shown to be effective in reducing pain. The purpose of this study was to determine whether a prior administration of a sweet-tasting solution has an effect on dental injection pain. A total of 56 healthy children needing bilateral maxillary primary canine extraction were included in this split-mouth randomized clinical trial.In the test side, dental injection (local infiltration) was applied after the patient received a sweet-tasting solution, while in the control side sterile water was administered. The patients' demographic characteristics, body mass index (BMI), and sweet taste preference were recorded. Pain perception during injection was measured using visual analogue scale (VAS) and sound, eye, body movement (SEM). Mean VAS (28.30±6.43) and SEM (2.14±0.78) in the test side were lower than the control side (45.80±7.17 and 2.95±1.00). It was shown that higher BMI was associated with reduction in the analgesic effect, while the individual's tendency to sweetness increased pain reduction. Sweet taste administration before dental injections in children helps to control the associated pain. This effect is influenced by the individual's sweet taste tendency and BMI.

Sustained efficacy of kangaroo care for repeated painful procedures over neonatal intensive care unit hospitalization: a single-blind randomized controlled trial.

Preterm neonates hospitalized in the neonatal intensive care unit undergo frequent painful procedures daily, often without pain treatment, with associated long-term adverse effects. Maternal-infant skin-to-skin contact, or kangaroo care (KC), and sweet-tasting solutions such as sucrose are effective strategies to reduce pain during a single procedure; however, evidence of sustained efficacy over repeated procedures is limited. We aimed to determine the relative sustained efficacy of maternal KC, administered alone or in combination with 24% sucrose, to reduce behavioral pain intensity associated with routine neonatal procedures, compared with 24% sucrose alone. Stable preterm infants (n = 242) were randomized to receive KC and water, KC and 24% sucrose, or 24% sucrose before all routine painful procedures throughout their neonatal intensive care unit stay. Pain intensity, determined using the Premature Infant Pain Profile, was measured during 3 medically indicated heel lances distributed across hospitalization. Maternal and neonatal baseline characteristics, Premature Infant Pain Profile scores at 30, 60, or 90 seconds after heel lance, the distribution of infants with pain scores suggesting mild, moderate, or severe pain, Neurobehavioral Assessment of the Preterm Infant scores, and incidence of adverse outcomes were not statistically significantly different between groups. Maternal KC, as a pain-relieving intervention, remained efficacious over time and repeated painful procedures without evidence of any harm or neurological impact. It seemed to be equally effective as 24% oral sucrose, and the combination of maternal KC and sucrose did not seem to provide additional benefit, challenging the existing recommendation of using sucrose as the primary standard of care.

Inactivation of the basolateral amygdala suppresses the expression of taste neophobia but not the retrieval process in attenuation of neophobia

Taste neophobia is a behavior seen in rodents that involves reduction in the consumption of a novel food or drink. In the absence of negative post-ingestive consequences, consumption increases with exposure. In this study, we examined the effect of pharmacological inactivation of the basolateral nucleus of the amygdala (BLA) on taste neophobia in rats using muscimol, a GABAA receptor agonist. Rats treated with muscimol infused into the bilateral BLA showed a suppressed but not totally abolished neophobic reaction to a novel saccharin solution compared to that observed in control rats. This result indicates that BLA function is important, but not essential, for expression of a neophobic reaction to a novel sweet taste solution. However, infusion of muscimol into the BLA did not disrupt attenuation of neophobia, which implies the presence of a retrieval process in safe taste memory.

Assessing Reality Testing in Mice Through Dopamine-Dependent Associatively Evoked Processing of Absent Gustatory Stimuli.

Impairments in reality testing are core features of numerous neuropsychiatric conditions. However, relatively few animal models have been developed to assess this critical facet of neuropsychiatric illness, thus impeding our understanding of the underlying central systems and circuits. Using mice in which dominant-negative Disrupted-in-Schizophrenia-1 is expressed throughout central nervous system circuitry (DN-DISC1-PrP), the capacity for an auditory conditioned stimulus (CS) to evoke perceptual processing of an absent sucrose solution was examined. At test, during CS presentations, DN-DISC1-PrP mice consumed more water and displayed a licking profile that is more typically revealed while ingesting a sweet-tasting solution. DN-DISC1-PrP mice also displayed greater c-fos expression in the insular (gustatory) cortex when consuming water in the presence of the CS. This capacity for the CS to more readily substitute for the taste features of the absent sucrose solution in DN-DISC1-PrP mice was attenuated following systemic treatment with the antipsychotic haloperidol. Conversely, social isolation during adolescence promoted the manifestation of these effects. These results provide strong validation for using associative learning procedures to examine dopamine-mediated reality testing associated with insular cortex activation.

COMPARISON OF THE ANALGESIC EFFICACY OF EXPRESSED BREAST MILK AND 25% DEXTROSE DURING THE FIRST HEPATITIS B VACCINATION

Background: Injectable vaccines are a common source of pain and distress for newborn babies. Sweet-tasting solutions such assucrose and 25% dextrose (25D) are described as effective strategies for pain relief in newborns. Objective: This study was doneto 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 atertiary care hospital in southern India. The participants included healthy term babies and late preterm babies at the clinic duringtheir routine dose of Hep B at birth, during the study period from June 2017 to December 2017. A total of 70 consecutive neonateswere randomly allocated into two groups. 2 ml of either EBM or 2 ml of 25D solution was given 1 min before the injection. Theoutcome variables recorded were the duration of cry after injection and Neonatal Infant Pain Scale (NIPS) scores for both thegroups. Results: The duration of cry was found to be slightly higher in the group receiving EBM than those receiving 25D, althoughit 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.