A small dose of sugar given to newborns before common hospital procedures, such as blood draws, can significantly reduce pain, according to a newly published Cochrane review. The findings, released today, confirm the effectiveness of sucrose as a simple, low-cost analgesic for infants undergoing painful but necessary medical interventions.
The review, which analyzed data from 29 clinical trials encompassing over 2,700 preterm and full-term babies, found that sucrose likely reduces pain during and immediately after venepuncture – the process of drawing blood with a needle – when compared to receiving no treatment, water, or standard care. Researchers also discovered that the pain-relieving effects of sucrose were enhanced when administered alongside non-nutritive sucking, like that provided by a pacifier.
“Newborn babies undergo frequent needle procedures in hospital without any pain relief or comforting measures, even though older children and adults rarely have these procedures done without pain care,” said Mariana Bueno, lead author of the review and researcher at the University of Toronto. “The evidence shows that a small amount of sucrose given just before the procedure is a simple, fast and effective way to reduce that pain. Our review helps clinicians utilize this evidence more confidently and consistently in practice.”
The need for effective pain management in newborns is particularly acute for preterm infants in neonatal intensive care units (NICUs), who are subjected to numerous painful procedures due to their medical fragility. Untreated pain in these vulnerable infants has been linked to poorer physical growth and potential adverse effects on brain development, researchers noted.
While sucrose has been recommended in clinical guidelines for years, its implementation has been inconsistent. The Cochrane review highlights significant variations in how sucrose is administered, including differences in dosage, and timing. “What stood out to me when doing this review was the wide variation in how sucrose was given to newborns,” Bueno added.
Co-author Ligyana Candido, from the University of Ottawa, emphasized the accessibility of the intervention. “Parents may be surprised to learn that something as simple as a few drops of sugar solution can make a real difference to their baby’s comfort during blood tests,” she said. “This is a low-cost, safe intervention that works within minutes, and it can be especially helpful when other comforting methods like skin-to-skin contact or breastfeeding aren’t possible.”
The review found no immediate side effects from the small amounts of sucrose used for pain relief. However, the authors caution that the studies examined focused on short-term effects, and further research is needed to assess the potential long-term consequences of repeated sucrose use in babies who require prolonged stays in neonatal care.
To ensure safe and consistent clinical practice, the researchers recommend that sucrose administration be governed by formal medication protocols that specify appropriate timing and dosage for painful procedures. Jiale Hu, a co-author from Virginia Commonwealth University, stated, “To ensure safety and clinical consistency, sucrose must be administered under formal medication protocols that define specific timing and dosage for painful procedures.”
The authors suggest future research should focus on comparing the effectiveness of various comfort measures – including skin-to-skin contact, breastfeeding, and sucrose – directly against each other, rather than solely comparing them to a no-treatment control group. They also call for further investigation into the long-term effects of repeated sucrose exposure in infants undergoing extended neonatal care.