FULL DETAILS (Read-only)  -> Click Here to Create PDF for Current Dataset of Trial
CTRI Number  CTRI/2025/07/090168 [Registered on: 04/07/2025] Trial Registered Prospectively
Last Modified On: 03/07/2025
Post Graduate Thesis  No 
Type of Trial  Interventional 
Type of Study   Preventive 
Study Design  Randomized, Parallel Group, Multiple Arm Trial 
Public Title of Study   Comparing the efficacy of breast milk and sweet solution in reducing pain during blood sampling in newborn babies 
Scientific Title of Study   Comparing the efficacy of breast milk and dextrose solutions in reducing procedural pain during venipuncture in neonates 
Trial Acronym  NIL 
Secondary IDs if Any  
Secondary ID  Identifier 
NIL  NIL 
 
Details of Principal Investigator or overall Trial Coordinator (multi-center study)  
Name  Nikunj Bhatnagar 
Designation  Senior Resident 
Affiliation  ESIC Hospital and PGIMSR, Basaidarapur 
Address  Neonatal ICU, Department of Pediatrics, 1st floor, C-block, ESIC Hospital and PGIMSR, Basaidarapur, Ring Road, Delhi - 110015

West
DELHI
110015
India 
Phone  7982945101  
Fax    
Email  nikunjbhatnagar10@gmail.com  
 
Details of Contact Person
Scientific Query
 
Name  Nikunj Bhatnagar 
Designation  Senior Resident 
Affiliation  ESIC Hospital and PGIMSR, Basaidarapur 
Address  Neonatal ICU, Department of Pediatrics, 1st floor, C-block, ESIC Hospital and PGIMSR, Basaidarapur, Ring Road, Delhi - 110015


DELHI
110015
India 
Phone  7982945101  
Fax    
Email  nikunjbhatnagar10@gmail.com  
 
Details of Contact Person
Public Query
 
Name  Nikunj Bhatnagar 
Designation  Senior Resident 
Affiliation  ESIC Hospital and PGIMSR, Basaidarapur 
Address  Neonatal ICU, Department of Pediatrics, 1st floor, C-block, ESIC Hospital and PGIMSR, Basaidarapur, Ring Road, Delhi - 110015


DELHI
110015
India 
Phone  7982945101  
Fax    
Email  nikunjbhatnagar10@gmail.com  
 
Source of Monetary or Material Support  
Neonatal ICU, Department of Pediatrics, 1st floor, C-block, ESIC Hospital and PGIMSR, Basaidarapur, Ring Road, Delhi - 110015 
 
Primary Sponsor  
Name  Nikunj Bhatnagar 
Address  ESIC and PGIMSR, Basaidarapur, Ring Road, Delhi 
Type of Sponsor  Other [Self] 
 
Details of Secondary Sponsor  
Name  Address 
NIL  NIL 
 
Countries of Recruitment     India  
Sites of Study  
No of Sites = 1  
Name of Principal Investigator  Name of Site  Site Address  Phone/Fax/Email 
Dr Nikunj Bhatnagar  ESIC Hospital  Neonatal ICU, Department of Pediatrics, 1st floor, C-block, ESIC and PGIMSR, Basaidarapur, Ring Road, Delhi - 110015
West
DELHI 
7982945101

nikunjbhatnagar10@gmail.com 
 
Details of Ethics Committee  
No of Ethics Committees= 1  
Name of Committee  Approval Status 
ESIC and PGIMSR IEC  Approved 
 
Regulatory Clearance Status from DCGI  
Status 
Not Applicable 
 
Health Condition / Problems Studied  
Health Type  Condition 
Patients  (1) ICD-10 Condition: R52||Pain, unspecified,  
 
Intervention / Comparator Agent  
Type  Name  Details 
Intervention  10% Dextrose  Administration of 5 ml of 10% dextrose orally by a paladai in 2 minutes by a staff nurse. She will clean excess solution, remove the paladai and envelope containing the name of solution. Then investigator and observer will enter the room and routine venepuncture for TSB sampling will be done along with recording the PIPP score (premature infant pain profile score) and vital (like heart rate, respiratory rate, spo2) followed by RBS estimation by heel prick one hour after the administration of solution  
Intervention  25% Dextrose  Administration of 2 ml of 25% dextrose orally by a paladai in 2 minutes by a staff nurse. She will clean excess solution, remove the paladai and envelope containing the name of solution. Then investigator and observer will enter the room and routine venepuncture for TSB sampling will be done along with recording the PIPP score (premature infant pain profile score) and vital (like heart rate, respiratory rate, spo2) followed by RBS estimation by heel prick one hour after the administration of solution  
Intervention  Expressed Breast Milk   Administration of 7 ml of Expressed breast milk of babys own mother orally by a paladai in 2 minutes by a staff nurse. She will clean excess milk from mouth of baby, remove the paladai and envelope containing the name of solution. Then investigator and observer will enter the room and routine venepuncture for TSB sampling will be done along with recording the PIPP score (premature infant pain profile score) and vital (like heart rate, respiratory rate, spo2) followed by RBS estimation by heel prick one hour after the administration of solution  
Comparator Agent  Premature infant pain profile score   standardised tool to assess pain in term and preterm infants. 
 
Inclusion Criteria  
Age From  0.00 Day(s)
Age To  28.00 Day(s)
Gender  Both 
Details  All vitally stable newborns of greater or equal to 37 weeks gestation who are on exclusive breast
feeding and have been admitted for phototherapy for jaundice requiring routine sampling of
total serum bilirubin by venepuncture 
 
ExclusionCriteria 
Details  Neonates with
1. Cerebral injury in form of perinatal asphyxia / hypoxic-ischemic encephalopathy /
meningitis / bilirubin induced neuro-disability
2. Any obvious congenital malformation like cleft palate, cleft lip.
3. Requiring more than one prick
4. Who have passed stools during procedure
5. Who are small for gestational age or large for gestational age 
 
Method of Generating Random Sequence   Computer generated randomization 
Method of Concealment   Sequentially numbered, sealed, opaque envelopes 
Blinding/Masking   Participant and Investigator Blinded 
Primary Outcome  
Outcome  TimePoints 
Measures the PIPP score of babies during venepuncture in 2 ml D-25% or 5 ml D-10% or 7 ml expressed breast milk groups  The principal investigator will record the PIPP score during venepuncture of baby, which will be recorded in the patient proforma.

 
 
Secondary Outcome  
Outcome  TimePoints 
Record the changes in Heart rate, Respiratory rate, SpO2 & RBS measurement after 1 hour of administration of 2 ml D-25% or 5 ml D-10% or 7 ml
expressed breast milk  
The observer will be recording the vital which will include heart rate, respiratory rate, SpO2. This measurement will be done at baseline (before venepuncture & before administration of test solution [intervention]), 0 minutes (during venepuncture), 1 minute, 3 minutes & 5 minutes after venepuncture.
The observer will also measure the RBS (random blood sugar) by heel prick 1 hour after administration of test solution.  
 
Target Sample Size   Total Sample Size="135"
Sample Size from India="135" 
Final Enrollment numbers achieved (Total)= "Applicable only for Completed/Terminated trials"
Final Enrollment numbers achieved (India)="Applicable only for Completed/Terminated trials" 
Phase of Trial   N/A 
Date of First Enrollment (India)   20/07/2025 
Date of Study Completion (India) Applicable only for Completed/Terminated trials 
Date of First Enrollment (Global)  Date Missing 
Date of Study Completion (Global) Applicable only for Completed/Terminated trials 
Estimated Duration of Trial   Years="0"
Months="6"
Days="0" 
Recruitment Status of Trial (Global)   Not Applicable 
Recruitment Status of Trial (India)  Not Yet Recruiting 
Publication Details   N/A 
Individual Participant Data (IPD) Sharing Statement

Will individual participant data (IPD) be shared publicly (including data dictionaries)?  

Response - YES
  1. What data in particular will be shared?
    Response - All of the individual participant data collected during the trial, after de-identification.

  2. What additional supporting information will be shared?
    Response -  Study Protocol
    Response -  Statistical Analysis Plan
    Response - Clinical Study Report

  3. Who will be able to view these files?
    Response - Anyone

  4. For what types of analyses will this data be available?
    Response - To achieve aims in the approved proposal.

  5. By what mechanism will data be made available?
    Response (Others) -  After completion of analysis, the research will be sent for publication to international neonatal journals or if unapproved then to indian journals of pediatrics.

  6. For how long will this data be available start date provided 01-05-2026 and end date provided 31-12-2090?
    Response - Immediately following publication. No end date.

  7. Any URL or additional information regarding plan/policy for sharing IPD? 
    Additional Information - NIL
Brief Summary  

Neonates admitted in NICU for various indications universally undergo some painful procedures in form of venepunctures and cannulation for blood testing. Such painful procedures in neonates have the capability to alter their homeostasis, creating an “allostatic load” rendering them prone to derangement in their physiology. Their inability to fully express themselves and subtle signs have the potential to be missed in events of painful procedures. Pharmacological methods for pain reduction applied in adults cannot be extrapolated in neonatal science. Many drugs become contraindicated and more often studies and evidence on their safety profile and side effects are lacking. This forces us to utilize non-pharmacological, neonatal friendly alternatives like breast feeding, kangaroo mother care (KMC) and administration of sweet substances like dextrose which have shown to be effective in reducing neonatal pain as evident in number of studies. While administration of 25% dextrose (osmolarity 1390 mOsm/L) has been found to be most effective in reducing pain in neonates in some studies and is routinely followed in some neonatal intensive care units, it is known that administration of hypertonic solutions to neonates result in adverse effects of vomiting and feed intolerance. Though multiple comparative studies between dextrose and breastmilk have been conducted, volume-based studies using different dextrose concentrations with same sugar amount is lacking. Such a study would aid in determining if low osmolarity sweet solutions (like 10% dextrose - osmolarity 505 mOsm/L) and breast milk (osmolarity 300 mOsm/L) with same sugar content can be as effective in producing analgesia in newborn babies thus preventing unnecessary administration of hypertonic solutions to the newborn. Therefore, this study holds the research hypothesis that there is an effect of 5 ml of 10% Dextrose and 7 ml of expressed breast milk in reducing procedural pain in term neonates as compared to 2 ml of 25% Dextrose as measured by premature infant pain profile score.

 In this study 135 term neonates (whose parents have consented for participating in study) admitted to NICU for neonatal jaundice requiring only phototherapy will be included. During routine sampling for total serum bilirubin, 5 ml of 10% dextrose OR 2 ml of 25 % dextrose OR 7 ml of mother’s expressed breast milk will be administered orally two minutes before sampling using a paladai. Sampling will be done as per the protocol for neonatal jaundice treatment. Baseline RBS will be taken and neonatal response to pain using PIPP score (premature infant pain profile score) will be recorded. One repeat RBS after one hour of administering solution will be taken. No extra sampling of the baby will be done. The responses will be recorded in a sheet of paper for later analysis which will be hidden from investigators till all data collection is complete. This will be a double blind, prospective, parallel group, randomised control trial and data analysis will be carried out using latest software.

 
Close