When newborns need medical care, even routine procedures can be challenging. Blood tests and other needle-based medical actions are common in the first days and weeks of life, especially for infants receiving treatment in neonatal intensive care units. These procedures are important for monitoring health, but they can also cause significant discomfort for babies whose nervous systems are still developing.

A simple and sweet solution may ease that pain, a review of clinical research suggests. According to the analysis, giving newborns a small amount of sucrose, a sugar solution, shortly before a needle procedure can reduce pain during and immediately afterward.

“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.”

The analysis reviewed results of randomized clinical trials involving more than 2,700 pre-term and full-term newborn babies who required venipuncture, a procedure in which blood is drawn from a vein using a needle. The research was conducted by an international team of investigators and led by Mariana Bueno, PhD, RN, an assistant professor at the University of Toronto's Lawrence S. Bloomberg Faculty of Nursing.

The goal of the review was to better understand the benefits and possible risks of sucrose as a pain-relief strategy for newborns. Hospitals have used sweet solutions for decades, but the researchers wanted stronger evidence about how well the method works during specific procedures.

To gather that evidence, the team searched several major databases to identify randomized controlled trials evaluating sucrose for pain relief in newborns up to 44 weeks.

The studies compared infants who received sucrose with those who received water, no treatment or standard comfort measures such as breastfeeding, skin-to-skin contact or non-nutritive sucking.

The sucrose dose varied widely across the studies, ranging from 0.1 milliliters per kilogram of body weight to about 2 milliliters delivered by syringe, dropper or pacifier.

Despite these differences, the overall findings were consistent: Babies who received sucrose showed lower pain scores during venipuncture and in the moments immediately afterward.

“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 Bueno, in a press release. “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 use this evidence more confidently and consistently in practice.”

The effect was particularly noticeable when sucrose was combined with non-nutritive sucking, such as a pacifier. This combination appeared to provide greater comfort than either strategy alone.

Sucrose should be used thoughtfully. Don't use it to sweeten anything a child might not like. Treat it more like a medication to be used during painful procedures.

Researchers measure infant pain using several validated scoring systems that evaluate babies' facial expressions, crying and body movements. In many of the trials included in the review, infants who received sucrose had significantly lower pain scores compared with babies who received no treatment or water.

Just as important, the review found no immediate adverse effects from the small amounts of sucrose use for pain relief. That safety profile makes the approach appealing for busy hospital settings, where clinicians look for methods that are effective, inexpensive and easy to administer.

Still, the researchers emphasize that sucrose should be used thoughtfully. The studies mainly examined short-term outcomes, and more research is needed to understand the long-term effects of repeated use in babies who spend extended time in neonatal care. The authors recommend treating sucrose more like a medication with clear protocols that specify when and how it should be used during painful procedures.

For parents whose newborns require frequent medical tests, the message is encouraging. Sometimes easing a baby's pain doesn't require complex technology, just a tiny bit of sweetness at the right moment.

The study is published in Cochrane Database of Systematic Reviews, part of the Cochrane Library.