***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    ***EXAMPLES*** 
    Input: Intraoral sucrose induces rapid and sustained calm in  crying newborns  and transiently increases mouthing and h and -mouth contact . To determine whether these effects are specific to sucrose and to explore which properties of orogustatory stimuli might contribute to this effect , 60 crying newborns were r and omized to receive 250 ul of 24 % sucrose solution , 0.25 % quinine hydrochloride solution , or corn oil as well as water in a mixed parallel crossover design . Relative to water , sucrose persistently reduced crying , and transiently increased mouthing and h and -mouth contact as previously demonstrated . While quinine produces a " disgust " face in calm infants , in crying infants it transiently decreased crying and increased mouthing , but did not affect h and -mouth contact .  Corn oil had no specific effect on crying , mouthing or h and -mouth contact . The results imply that crying newborns respond differentially to orogustatory stimuli , that taste " salience " rather than positive hedonic valence may account for initial crying reduction and increased mouthing , and that these behavioral effects are not induced by at least one lipid nutrient OBJECTIVE To investigate interventions that affect pain reduction during vaccination in infants and children attending a well-child unit . STUDY DESIGN A consecutive sample of 243 children between age 0 and 48 months receiving their routine vaccinations was r and omly assigned to 1 of the study groups . A total of 158 infants under age 6 months were r and omly assigned to breast-feeding or no breast-feeding during immunization , and 85 children age 6 to 48 months were r and omly assigned to receive 12 % sucrose solution , lidocaine-prilocaine cream , or no intervention . All children were evaluated for crying time and pain score by a pediatrician using the Neonatal Infant Pain Scale ( NIPS ) for those under age 12 months and the Children 's Hospital of Eastern Ontario Pain Scale ( CHEOPS ) for those over age 12 months . RESULTS Breast-feeding in infants under age 6 months and use of sucrose or lidocaine-prilocaine in children age 6 to 48 months significantly reduced crying time and pain scores compared with controls . No difference in outcome was seen between the sucrose and lidocaine-prilocaine treatment groups . CONCLUSIONS Here we exp and on previous findings by demonstrating that breast-feeding may have an analgesic effect up to age 6 months and that in older children , both sucrose and lidocaine-prilocaine reduce vaccination pain The effectiveness of sucrose as an analgesic agent for newborn infants was assessed during two st and ard painful hospital procedures : blood collection via heel lance and circumcision . Infants who drank 2 mL of a 12 % sucrose solution prior to blood collection cried 50 % less during the blood collection procedure than did control infants who had received 2 mL of sterile water .  Crying of infants who ingested sucrose returned to baseline levels within 30 to 60 seconds after blood collection whereas control infants required 2.5 to 3.0 minutes to return to baseline . Like findings were obtained for infants who received sucrose on a pacifier prior to and during circumcision . Specifically , control infants who underwent a  st and ard circumcision procedure  without intervention cried 67 % of the time . A water-moistened pacifier reduced crying to 49 % ( P less than .01 ) . Crying was reduced further to 31 % ( P less than .05 ) by providing infants with a sucrose-flavored pacifier to suck . These findings , which parallel results obtained in studies of pain in infant rats , provide a potent yet simple , benign intervention to help alleviate stress and pain routinely experienced by human infants Summary A  parent‐directed prenatal education module was demonstrated to increase  parental use of evidence ‐based pain management interventions  at routine 2‐month infant vaccinations . ABSTRACT Analgesic interventions are not routinely used during vaccine injections in infants . Parents report a desire to mitigate injection pain , but lack the knowledge about how to do so . The objective of this cluster‐r and omized trial was to evaluate the effect of a parent‐directed prenatal education teaching module about vaccination pain management on analgesic utilization at future infant vaccinations . Expectant mothers enrolled in prenatal classes at Mount Sinai Hospital in Toronto were r and omized to a 20‐30 minute interactive presentation about vaccination pain management ( experimental group ) or general vaccination information ( control group ) . Both presentations included a PowerPoint ( Microsoft Corporation , Redmond , WA , USA ) and video presentation , take‐home pamphlet , and “ Question and Answer ” period . The primary outcome was self‐reported utilization of breastfeeding , sugar water , or topical anaesthetics at routine 2‐month infant vaccinations . Between October 2012 and July 2013 , 197 expectant mothers from 28 prenatal classes participated ; follow‐up was obtained in 174 ( 88 % ) . Maternal characteristics did not differ ( P > 0.05 ) between groups . Utilization of one or more prespecified pain interventions occurred in 34 % of participants in the experimental group , compared to 17 % in the control group ( P = 0.01 ) . Inclusion of a pain management module in prenatal classes led to increased utilization of evidence ‐based pain management interventions by parents at the 2‐month infant vaccination appointment . Educating parents offers a novel and effective way of improving the quality of pain care delivered to infants during vaccination . Additional research is needed to determine if utilization can be bolstered further using techniques such as postnatal hospital reinforcement , reminder cards , and clinician education Background Although sucrose has been accepted as an effective analgesic agent for procedural pain in neonates , previous studies are largely in the NICU population using the procedure of heel lance . This is the first report of the effect of sucrose , pacifier or the combination thereof for the procedural pain of venipuncture in infants in the pediatric emergency department population . Methods The study design was a double ( sucrose ) and single blind ( pacifier ) , placebo-controlled r and omized trial – factorial design carried out in a pediatric emergency department . The study population was infants , aged 0 – 6 months . Eighty-four patients were r and omly assigned to one of four groups : a ) sucrose b ) sucrose & pacifier c ) control d ) control & pacifier . Each child received 2 ml of either 44 % sucrose or sterile water , by mouth . The primary outcome measure : FLACC pain scale score change from baseline . Secondary outcome measures : crying time and heart rate change from baseline . Results Sucrose did not significantly reduce the FLACC score , crying time or heart rate . However sub-group analysis revealed that sucrose had a much greater effect in the younger groups . Pacifier use reduced FLACC score ( not statistically significant ) , crying times ( statistically significant ) but not heart rate . Subgroup analysis revealed a mean crying time difference of 76.52 seconds ( p < 0.0171 ) ( 0–1 month ) and 123.9 seconds ( p < 0.0029 ) ( 1–3 month ) . For subgroup age > 3 months pacifier did not have any significant effect on crying time . Age adjusted regression analysis revealed that both sucrose and pacifier had significant effects on crying time . Crying time increased with both increasing age and increasing gestational age . Conclusion Pacifiers are inexpensive , effective analgesics and are easy to use in the PED for venipuncture in infants aged 0–3 months . The benefits of sucrose alone as an analgesic require further investigation in the older infant , but sucrose does appear to provide additional benefit when used with a pacifier in this age group . Trial registration Current Controlled Trials IS RCT Intraoral sucrose ( and other sweet carbohydrates ) induce rapid and sustained calming in  crying newborns  and transiently increase mouthing and h and -mouth contact ( " sucrose effects " ) . To investigate whether these effects are due to the sweetness of sucrose , 60 crying newborns were r and omized to receive 250 microL of 24 % sucrose solution , 0.12 % of aspartame solution of equivalent sweetness ( to adults ) , or 24 % polycose , a soluble carbohydrate that is only very slightly sweet ( to adults ) , as well as water in a mixed parallel crossover design . Relative to water , sucrose persistently reduced crying , and transiently increased mouthing and h and -mouth contact , as previously demonstrated . Aspartame also reduced crying , and transiently increased mouthing and h and -mouth contact , virtually mimicking the time course and the magnitude of the effects obtained in response to sucrose . By contrast , polycose solution had no specific effects on crying , mouthing , or h and -mouth contact . The results imply that the responses of crying newborns to intraoral sucrose are neither specific to sucrose nor to the general class of carbohydrates , and that these effects are more appropriately understood as " sweetness " effects To assess the characteristics of sucrose as a pain-reducing substance , crying in 72 newborn humans during and after blood collection via heel prick was determined . In the first study infants drank 2 ml of water or 2 ml of a 0.17 - 0.34- or 0.51-M sucrose solution 1 min prior to blood collection . In the second experiment , a delay of 30 , 60 , 90 , 120 or 240 s was imposed between sucrose intake and the initiation of blood collection . The dose-response function for concentration was flat . The most effective time delay was 120 s. The effectiveness of the 2-min interval accords with previous findings of endogenous opioid release caused by sucrose taste . The flat dose-response function extends findings in rats and humans that the calming and pain-reducing effects of sucrose are not influenced by either concentration or volume , suggesting that the transduction from gustatory afferent to opioid-mediated efferent is of an on-off nature and not grade OBJECTIVES To determine whether an oral sucrose solution improves pain response for infants undergoing bladder catheterization in an emergency department ( ED ) population . METHODS A r and omized , double-blinded study comparing the analgesic effects of a sucrose solution to placebo for infants < or = 90 days of age and requiring bladder catheterization . Infants with prior bladder catheterization , previous painful procedures that day , or neurological or genital abnormalities were excluded . Infants were assigned baseline pain scores and then given 2 mL of sucrose or water 2 minutes before catheterization . Trained pediatric ED nurses rated the infants for pain , presence of cry , and time to return to baseline . RESULTS Eighty-three patients were enrolled ; 40 were r and omized to sucrose , and 40 , to placebo .  Baseline pain scores were similar within each age group . Overall , sucrose did not produce a significant analgesic effect . In subgroup analysis , infants 1 - 30 days of age receiving sucrose showed a smaller change in pain scores ( 2.9 vs. 5.3 , p = 0.035 ) , were less likely to cry with catheterization ( 29 % vs. 72 % , p = 0.008 ) , and returned to baseline more rapidly after catheter removal ( 10 seconds vs. 37 seconds , p = 0.04 ) compared with infants who received placebo . Infants older than 30 days of age who received sucrose did not show statistically significant differences in pain scores , crying , or time to return to baseline behavior . CONCLUSIONS There was no overall treatment effect when using an oral sucrose solution before bladder catheterization in infants younger than 90 days of age . However , infants younger than or equal to 30 days of age who received sucrose had smaller increases in pain scores , less crying , and returned to baseline more rapidly than infants receiving placebo . Older infants did not show an improved pain response with oral sucrose Background . Colic is a behavioral syndrome of early infancy of unknown etiology whose core symptom is increased  crying . Both clinical anecdotal descriptions and controlled observations converge in suggesting that a defining characteristic of the crying behavior is the longer duration of the crying bouts , especially during the second month of life when colic is at its peak . This implies that , once infants with colic begin crying , they do not calm as well as infants without colic . To investigate this difference objective ly , we used response to sucrose taste as a probe of colic-normal differences in regulation of crying for three reasons . First , sucrose taste has been shown to be a potent regulator of crying in human newborns . Second , convergent evidence from studies in both nonhuman and human infants suggests that sucrose calming reflects the function of central distress regulatory systems that are opioid-dependent . Third , effectiveness of sucrose calming diminishes in normal infants by 4 to 6 weeks of age , consistent with the developmental increase in crying duration common to infants with and without colic . Consequently we predicted that , if the regulation of crying by sucrose taste is relevant to the crying of infants with colic , calming responses to sucrose taste should be less effective in 6-week-old infants with colic compared with those without . Objectives . To investigate the clinical observation that infants with and without colic differ in their ability to regulate their crying behavior , our primary objective was to determine if there were differential crying responses to intraoral sucrose tastes ( relative to water ) in crying infants with and without colic . Based on previous studies of calming responses to sucrose taste , it was predicted that sucrose-specific calming before a feeding would be less effective in infants with colic than in those without . A secondary and more exploratory aim was to assess calming responses to sucrose ( relative to water ) on spontaneous crying after a feed in both groups . Methods . Nineteen infants meeting modified Wessel 's criteria for colic were compared with 19 age- and sex-matched 
    Output:
    
Based on the two studies by the same author , there was no evidence of analgesic effects of sweet taste in school-aged children .