Cochrane reviewers investigated how well sucrose (table sugar) works as a reliever of pain in newborn babies who are having painful procedures (e.g. We identified 74 studies that reported on a total of more than 7000 infants in this Cochrane Review. Twenty-nine studies reported on adverse events (harms of the sucrose and other treatments) and found that the number of minor adverse events (e.g. Additional research is needed to determine the minimally effective dose of sucrose during a single painful procedure and the effect of repeated sucrose administration on immediate (pain intensity) and long-term (neurodevelopmental) outcomes. More than 150 published studies relating to sweet-taste-induced calming and analgesia in human infants have been identified, of which 100 (65%) include sucrose. Babies under 1 should be given Pedialyte alongside breastfeeding or formula feeding, but only under medical guidance. Sucrose action is temporary and analgesic - not sedative. Obes Sci Pract. choking or gagging) was very low, and was similar in the different groups (so not attributable to the sucrose treatment). We performed electronic and manual literature searches in February 2016 for published randomised controlled trials (RCTs) in the Cochrane Central Register of Controlled Trials (CENTRAL; The Cochrane Library, Issue 1, 2016), MEDLINE (1950 to 2016), EMBASE (1980 to 2016), and CINAHL (1982 to 2016). Sweet solutions for procedural pain in infants. Sweet tasting solutions for reduction of needle-related procedural pain in children aged one to 16 years. Reduced infant response to a routine care procedure after sucrose analgesia. Sweet-ease® may be used if your baby is going to the operating room or having deep sedation in the sedation clinic to complete a painful procedure. The registered nurse (RN) May 27, 2010 -- … Recommended dosage is typically correlated to patient weight up to 3kg, with a full 2ml ampoule appropriate above 3kg. Adv Neonatal Care. Handbook of Non Drug Intervention (HANDI) Project Team. Scientific evidence has shown that small babies feel We do not know exactly how sucrose works to comfort babies. Evidence from studies that could not be included in RevMan-analyses supported these findings. More than 150 published studies relating to sweet-taste-induced calming and analgesia in human infants have been identified, of which 100 (65%) include sucrose.  |  National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. The analgesic properties of intraoral sucrose: an integrative review. It is commonly used prior to and during procedures that may cause discomfort to the infant.†. Sucrose has been shown to minimise pain and discomfort for infants less than 3 months of age during minor procedures. Sucrose has been widely recommended for routine use during painful procedures in newborn and young infants, yet these recommendations have not been translated into consistent use in clinical practice. grimace) are present), or a combination of these and long-term neurodevelopmental outcomes. Results from only a few studies could be combined in meta-analyses and for most analyses the GRADE assessments indicated low- or moderate-quality evidence. Pain Res Manag. Many factors may play a role in this poor uptake of research findings in the clinical setting. Oral sucrose will not always eliminate all crying, but is known to significantly reduce the physiological stress of pain. Glycerin & Caprylic/Capric Triglyceride & Aqua & Sucrose Laurate & Sucrose Stearate; COSMOS approved, Non-GMO, Vegan, RSPO certified; Add To Enquiry View Formulations Sucragel® AOF. J. Paediatr. CTP-79854/Canadian Institutes of Health Research/Canada, MOP-231330/Canadian Institutes of Health Research/Canada, MOP-86605/Canadian Institutes of Health Research/Canada. Administration. Sucrose may be inadequate for painful procedures lasting longer than this and alternative analgesia should be considered. 2020 Aug 18;21(16):5929. doi: 10.3390/ijms21165929. We use cookies to improve your experience on our site. Aroke EN, Powell-Roach KL, Jaime-Lara RB, Tesfaye M, Roy A, Jackson P, Joseph PV. When babies come into hospital they sometimes need to have procedures which may cause them to be uncomfortable, stressed or be in pain. doi: 10.1371/journal.pone.0153187. It can also be given with other medications to control pain. Sucrose for analgesia in newborn infants undergoing painful procedures. Harrison D, Yamada J, Adams-Webber T, Ohlsson A, Beyene J, Stevens B. Cochrane Database Syst Rev. Sucrose is effective for reducing procedural pain from single events such as heel lance, venipuncture and intramuscular injection in both preterm and term infants. Codipietro L, Bailo E, Nangeroni M, Ponzone A, Grazia G. Pain Pract. A small amount of 24% sucrose given 2 minutes ahead of time, reduces pain caused by tests and treatments like: Study Shows Infants Feel Less Pain When They Drink a Sugary Solution Before Vaccination. The review found that in the majority of studies sucrose had some effect on pain. Sucrose as analgesia. Art. It can be given to babies before a painful procedure. Many centres around the world routinely give a few drops of sucrose solution in to the baby’s mouth a couple of minutes before the painful procedure. 100% natural, COSMOS approved emulsifier and oil thickener. We believe that they might have overstated their conclusions and suggest a more cautious interpret-ation of the study fi ndings. Sucrose (sugar) providespain relieffornewborn babies having painful events such as needles or heel pricks. 2006. Notably, the mechanism of sweet-taste-induced analgesia is still not precisely understood, which has implications for using research evidence in practice. Analgesic techniques in minor painful procedures in neonatal units: a survey in northern Italy. The quality of evidence was low or moderate in favour for the use of … NLM The following chart gives guidance on typical dosages for both 30% glucose and 24% sucrose solutions. Although sucrose has been widely studied as a pain reliever for newborn babies, most studies have included few babies and have used many different measures of pain to assess its effectiveness. Child Health 42(1–2), 6–9). eCollection 2019 Jun. Besides, in some cultures, it is used as a traditional supplemental feeding along with breast milk. However, the longer-term effects of sucrose, especially for extremely premature babies, who are at the greatest risk of receiving repeat doses, is not known. From biology to behavior: a cross-disciplinary seminar series surrounding added sugar and low-calorie sweetener consumption. Our health evidence - how can it help you. Sucrose is effective for reducing procedural pain from single events such as heel lance, venipuncture and intramuscular injection in both preterm and term infants. heel lance and venipuncture) have, until relatively recently, been lacking. doi: 10.1002/14651858.CD008408.pub3. Sylvetsky AC, Hiedacavage A, Shah N, Pokorney P, Baldauf S, Merrigan K, Smith V, Long MW, Black R, Robien K, Avena N, Gaine C, Greenberg D, Wootan MG, Talegawkar S, Colon-Ramos U, Leahy M, Ohmes A, Mennella JA, Sacheck J, Dietz WH. 2019 Apr 11;5(3):203-219. doi: 10.1002/osp4.334. A prescription of sucrose is available to all eligible babies within the neonatal unit and documentation of appropriate use of sucrose prior to painful procedures. 2011 Apr;11(2):83-92; quiz 93-4. doi: 10.1097/ANC.0b013e318210d043. Babies in the placebo groups (all immunization times) spent the most time crying. Clipboard, Search History, and several other advanced features are temporarily unavailable. Two convenient sizes The 2 mL vial with no preservatives, simplifies workflow by allowing sucrose to be applied directly onto the tip of an infant's tongue or buccal surface. 2011 Mar-Apr;11(2):154-9. doi: 10.1111/j.1533-2500.2010.00406.x. Scope For use within neonatal units within the East of England Neonatal ODN 2. The use of oral sucrose has been the most extensively studied pain intervention in newborn care to date. Taste the Pain: The Role of TRP Channels in Pain and Taste Perception. More than 150 published studies relating to sweet-taste-induced calming and analgesia in human infants have been identified, of which 100 (65%) include sucrose. crying, grimacing) were assessed by scoring systems for pain used by health care professionals to measure the pain that babies are experiencing. Sugar water may offer some pain relief for babies, but should only be administered by a pediatrician. as a solution squirted into the mouth, or on a pacifier (also called a soother or dummy), and whether there are any safety concerns about using sucrose to relieve pain. Sucrose is not effective in reducing pain from circumcision. eCollection 2016. We could not identify an optimal dose due to inconsistency … Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. A WeeThumbie or Soothie pacifier can be used to help administer Sweet-Ease Natural, and help calm and soothe distressed babies up to six months of age. 2016 Apr 14;11(4):e0153187. Cochrane Database of Systematic Reviews 2016, Issue 7. Heel lance was the painful procedure in 38 studies, and venipuncture in nine; the remaining studies investigated a wide variety of other minor painful procedures. : CD001069. COVID-19 is an emerging, rapidly evolving situation. J. Paediatr. We could not identify an optimal dose due to inconsistency in effective sucrose dosage among studies. The effectiveness of sucrose for reducing pain/stress from other interventions such as arterial puncture, subcutaneous injection, insertion of nasogastric or orogastric tubes, bladder catherization, eye examinations and echocardiography examinations are inconclusive. Sucrose is considered a food product, and does not require a prescription. Can my baby have oral sucrose? The use of oral sucrose has been the most extensively studied pain intervention in newborn care to date. 2006. The quality of evidence was low or moderate in favour for the use of sucrose for other painful procedures. Once non-pharmacological measures have been implemented, oral sucrose analgesia may be used in babies in Level II NICU and the Parent Infant Nursery. Cerritelli S, Hirschberg S, Hill R, Balthasar N, Pickering AE. Glucose or sucrose solution is normally indicated for babies up to four months of age and generally considered more effective the younger the infant. We used the standard methods of the Cochrane Neonatal. This site needs JavaScript to work properly. The sucrose solution works by your baby tasting the sweetness on the tongue. https://www.nhs.uk/news/pregnancy-and-child/sugar-not-a-painkiller-for-babies Control interventions included no treatment, water, glucose, breast milk, breastfeeding, local anaesthetic, pacifier, positioning/containing or acupuncture.  |  Your baby does not need to drink the sucrose. Measures of pain were lower in the breastfeeding group. Oral sucrose is a mild analgesic and should only be used clinically for the reduction of pain during minor procedures. Please enable it to take advantage of the complete set of features! Must be prescribed on the drug chart (as required) or administered under patient group directive Will only be effective if administered orally dence, sucrose is not utilized in many settings for management of acute procedural pain (Harrison, D., et al. This simple strategy can be promoted in institutions caring for sick babies, as a method of reducing behavioural responses to procedural pain. Sucrose solution can be used to help reduce your baby’s distress during these procedures. There is some moderate-quality evidence that sucrose in combination with other non-pharmacological interventions such as non-nutritive sucking is more effective than sucrose alone, but more research of this and sucrose in combination with pharmacological interventions is needed. ® Here is a list of other times Sweet-ease® ® may be used: • Poking a heel for a lab The studies used a variety of delivery methods for the sucrose solution (oral syringe, dropper or sucrose-dipped pacifier), as well as a range of concentrations and volumes of dose. Conclusion: Oral sucrose was effective in reducing behavioural responses to pain upon heel lance and in the period following completion of a heel lance procedure in this group of sick hospitalized infants. Despite this evidence, sucrose is not utilized in many settings for management of acute procedural pain (Harrison, D., et al. Pain medicine is usually given for major painful events (such as surgery), but may not Reported adverse effects were minor and similar in the sucrose and control groups. EOE Neonatal ODN Page 2 of 9 1. There is conflicting evidence for whether sucrose reduces pain for other minor painful procedures and further research is needed to investigate these more thoroughly. The mechanism is an orally mediated increase in endogenous opioid. There was high-quality evidence for the beneficial effect of sucrose (24%) with non-nutritive sucking (pacifier dipped in sucrose) or 0.5 mL of sucrose orally in preterm and term infants: Premature Infant Pain Profile (PIPP) 30 s after heel lance WMD -1.70 (95% CI -2.13 to -1.26; I2 = 0% (no heterogeneity); 3 studies, n = 278); PIPP 60 s after heel lance WMD -2.14 (95% CI -3.34 to -0.94; I2 = 0% (no heterogeneity; 2 studies, n = 164). RCTs in which term or preterm neonates (postnatal age maximum of 28 days after reaching 40 weeks' postmenstrual age), or both, received sucrose for procedural pain. Protocol for the use of sucrose solution for procedural pain management Sucrose Reduces distress associated with painful procedures in babies < 3 months of age Is safe, and easily administered. 3.7 Options for products: Sucrose solution diluted from simple syrup to 24% is kept for one week in a refrigerator, and when taken to the bedside is used within 4 hours. Practice is benchmarked annually and action plans are formulated in response to the findings. Algopedol Sucrose 24% Solution can be used to help calm and comfort stressed babies when they are undergoing painful procedures including heel pricks and eye exams. Pain assessment and procedural pain management practices in neonatal units in Australia. Little things that help during a painful procedure. 24% sucrose is not a medicine; it is another name for sugar water. With only a few exceptions, sucrose, glucose, or other sweet solutions reduced pain responses during commonly performed painful procedures in diverse populations of infants up to 12 months of age. The effects of sucrose on long-term neurodevelopmental outcomes are unknown. By Denise Mann. Sucrose for analgesia in newborn infants undergoing painful procedures Healthcareprofessionals needstrategies toreduce newborn babies’ pain. We identified high-quality evidence that sucrose reduces pain for heel lance, venipuncture and intramuscular injection. The studies used a range of pain assessment scales to measure their results. Milazzo et al. Procedures where Sucrose may be useful are heel pricks, venepuncture, intravenous cannula insertion, intramuscular injections, adhesive tape removal and lumbar puncture. Sucrose has been examined for its calming effects in crying newborns and its pain-relieving effects for invasive procedures in full-term and premature newborns. We searched the medical literature widely up to February 2016 for studies that investigated the pain-relieving effect of sucrose for minor medical procedures in newborn full-term and premature babies. Int J Mol Sci. 2001 Spring;6(1):21-8. doi: 10.1155/2001/376819. DOI: 10.1002/14651858.CD001069.pub5, Copyright © 2021 The Cochrane Collaboration. No major adverse events were reported. Stevens B, Yamada J, Ohlsson A, Haliburton S, Shorkey A, Stevens B, Yamada J, Ohlsson A, Haliburton S, Shorkey A. Sucrose for analgesia in newborn infants undergoing painful procedures. The babies' pain responses (e.g. Seventy-four studies enrolling 7049 infants were included. SweetUms is a 24% Sucrose Solution to help calm and soothe babies. No. an injection, or heel lance, or insertion of a needle to obtain a blood sample (venipuncture), or eye examinations). Sucrose 24% Solution How does this work? Most trials indicated some benefit of sucrose use but that the evidence for other painful procedures is of lower quality as it is based on few studies of small sample sizes. Our main outcome measures were composite pain scores (including a combination of behavioural, physiological and contextual indicators). Oral sucrose for procedural pain in infants Rebeccah Slater and colleagues (Oct 9, p 1225) 1 question the benefi t of sucrose for alleviating procedural pain in infants. We identified high-quality evidence that sucrose reduces pain for heel lance, venipuncture and intramuscular injection. (sucrose) and water that can be used to decrease pain in infants. However, sucrose does not provide effective pain relief during circumcision. 2009 Mar;123(3):e425-9. 51 term babies, 4 days old (55 venepunctures) randomised to 2ml 24% sucrose, 2ml spring water, 1g EMLA or sucrose and EMLARCT (level 1b) Crying time/Heart rate/O2 saturation/Respiratory rate: Sucrose (compared with sterile water as placebo) significantly reduced crying time p=0.001 and heart rate p=0.04. NIH How does sucrose work? With only a few exceptions, sucrose, glucose, or other sweet solutions reduced pain responses during commonly performed painful procedures in diverse populations of infants up to 12 months of age. There was high-quality evidence that sucrose reduces different measures of newborn pain during heel lance, venipuncture and intramuscular injection. The analgesic effect lasts 5-8 minutes making it an ideal strategy for the management of short term pain.Oral sucrose is most effective for preterm and term neonates (less than 28 days old). The affect of sucrose is enhanced when combined with a concomitant breast feed, or where this is not possible, non-nutritive sucking using a dummy. Breastfeeding during immunization should be offered to women and their babies routinely as a pain avoidance procedure. Johnston et al. Supplied as an easy-to-use liquid, and perfect for clear gel-to-milk cleansers, and many other cosmetic formulations. Hatfield LA, Chang K, Bittle M, Deluca J, Polomano RC. We included randomised controlled trials only, as these provide the most reliable medical evidence. Although there are ways to manage the pain of surgery, medical illness and major procedures, ways of preventing or reducing pain from minor medical procedures (e.g. Pediatrics. doi: 10.1002/14651858.CD001069.pub5. Babies 6 months and younger can have oral sucrose. Stevens B, Yamada J, Ohlsson A, Haliburton S, Shorkey A. Cochrane Database Syst Rev. We assessed the risk of bias of included trials using the Cochrane 'Risk of bias' tool, and assessed the quality of the evidence using the GRADE system. Many centres around the world routinely give a few drops of sucrose solution in to the baby’s mouth a couple of minutes before the painful procedure. Sucrose use in extremely preterm, unstable, ventilated (or a combination of these) neonates needs to be addressed. 2016 Jul 16;7(7):CD001069. There was high-quality evidence for the use of 2 mL 24% sucrose prior to venipuncture: PIPP during venipuncture WMD -2.79 (95% CI -3.76 to -1.83; I2 = 0% (no heterogeneity; 2 groups in 1 study, n = 213); and intramuscular injections: PIPP during intramuscular injection WMD -1.05 (95% CI -1.98 to -0.12; I2 = 0% (2 groups in 1 study, n = 232). From the WebMD Archives . We did not impose language restrictions. Sugar Water Eases Vaccine Pain for Babies. One reason may be related to important knowledge and research gaps concerning analgesic effects of sucrose. No serious side effects or harms have been documented with this intervention. In this randomized controlled trial, during immunization, 120 babies up to six months old were randomized to breastfeeding, oral sucrose, or the usual comforting measures. Sucrose will not completely stop all of the pain, but the baby will have a slower heart beat and less crying during and after the procedure. Thirty-eight studies included full-term babies only, 31 included premature babies only, and five included both full-term and premature babies. Secondary outcomes included separate physiological and behavioural pain indicators. Dose: 0.2ml of a 66.7% Sucrose Solution (Syrup BP, 0.667g/ml). Scientific evidence has shown that small babies feel procedural pain very acutely … Administration of oral sucrose with and without non-nutritive sucking is the most frequently studied non-pharmacological intervention for procedural pain relief in neonates. For babies who weight more than 1000 grams this can be partial doses. PLoS One. We reported a mean difference (MD) or weighted MD (WMD) with 95% confidence intervals (CI) using the fixed-effect model for continuous outcome measures. Further investigation of repeated administration of sucrose in neonates is needed. Sucrose …  |  Sucrose can be used to help calm and comfort stressed babies when they are undergoing painful procedures including heel pricks and eye exams. No serious side effects or harms have been documented with this intervention. 4. Sucrose should not be used to calm a crying child. Mechanisms of sucrose and non-nutritive sucking in procedural pain management in infants. Would you like email updates of new search results? To determine the efficacy, effect of dose, method of administration and safety of sucrose for relieving procedural pain in neonates as assessed by validated composite pain scores, physiological pain indicators (heart rate, respiratory rate, saturation of peripheral oxygen in the blood, transcutaneous oxygen and carbon dioxide (gas exchange measured across the skin - TcpO2, TcpCO2), near infrared spectroscopy (NIRS), electroencephalogram (EEG), or behavioural pain indicators (cry duration, proportion of time crying, proportion of time facial actions (e.g. Activation of Brainstem Pro-opiomelanocortin Neurons Produces Opioidergic Analgesia, Bradycardia and Bradypnoea. Sucrose given by mouth (oral sucrose) can reduce pain during tests and treatments in babies up to 18 months. USA.gov. Although sucrose has been widely studied as a pain reliever for newborn babies, most studies have included few babies and have used many different measures of pain to assess its effectiveness. Many factors may play a role in this poor uptake of research findings in the clinical setting. What else do I need to know about sucrose? Pain assessment and procedural pain management practices in neonatal units in Australia. The use of oral sucrose has been the most extensively studied pain intervention in newborn care to date. When can Sweet-ease® be used? Skin-to-skin care with newborns cuts down procedural pain, Breastfeeding or breast milk for procedural pain in neonates, Propofol use for sedation in newborn babies undergoing procedures, Dexmedetomidine for analgesia and sedation in newborn infants receiving mechanical ventilation, Relieve baby’s pain without drugs. The aim of this article is to review what is known about the mechanisms of sucrose-induced analgesia; highlight existing evidence, knowledge gaps, and current controversies; and provide directions for future research and practice. Sugar water is a solution made with sucrose or glucose and water. We did not identify any studies that received funding from the industry. Dosage instructions. Sucrose treatment was compared with giving the babies a similar volume of water, a pacifier, routine care, breastfeeding, 'facilitated tucking' (holding the infant in a flexed position with arms close to the body and hands placed to promote sucking), laser acupuncture, swaddling, warmth, anaesthetic cream for the skin (EMLA), or a combination of these. Sucrose is safe for all babies aged up to 18 months, except those who: are premature; have low birth weight; have unstable sugar levels; have a gastrointestinal disorder (such as necrotizing enterocolitis) If you are worried about using sucrose with your infant, ask your health-care team for advice. Before Vaccination babies before a painful procedure controlled trials only, 31 premature... Effects were minor and similar in the sucrose solution can be used to calm a crying child younger can oral! Babies having painful events such as needles or heel pricks the different groups all. Study fi ndings scoring systems for pain relief for babies up to 3kg, with parent! ; 123 ( 3 ):203-219. doi sucrose for babies 10.1097/ANC.0b013e318210d043 analgesic affect groups ( all immunization times ) the! And several other advanced features are temporarily unavailable having painful events such as needles or heel pricks invasive! 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