The Response of Crying Newborns to Sucrose

Barr, Ronald G.; Pantel, Mitchell S; Young, Simon N.; Wright, James K.; Hendricks, Lisa Anne; Gravel, Ron

doi:10.1016/s0031-9384(98)00294-7

Cited by 103 publications

(57 citation statements)

References 36 publications

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“…Secondly because of presence of sweet taste in the mouth; researchers have termed this as "sweetness effect". 21 The peak response time of 2 minutes is the time needed for taste stimulation to activate the endogenous opioid system for the release of endorphins. The duration of action is 5-10 minutes.…”

Section: Discussionmentioning

confidence: 99%

Comparison of analgesic effect of 24% sucrose and breast milk in healthy infants less than 2 months of age

Kavthekar

Patil

Kurane

et al. 2016

Int J Contemp Pediatr

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INTRODUCTIONThe myth regarding neonatal pain suggests that because of neurological immaturity, neonates do not experience pain. However, studies have shown that pain pathways as well as cortical and subcortical centres, necessary for pain perception are well developed late in gestation and physiological and behavioural responses to pain are well documented in neonates.1 Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage. It is difficult to assess pain in infants, as infants cannot verbalise their pain ,as they are dependent on others to recognize it, intervene it, treat it. Many newborn babies undergo painful procedures like heel pricks, venepuncture and intramuscular injection for immunization, such procedures inflict distinct physiological, behavioral, hormonal and metabolic changes.3 Moreover painful experience very early in life can promote somatization later in life. 4 Dextrose and sucrose in varying concentration have been shown to relive pain during venepuncture or intramuscular injection. [5][6][7][8][9][10][11][12] Breastfeeding or expressed breast milk have ABSTRACT Background: Many newborns undergo painful procedures like heel pricks, venepuncture and intramuscular injection for immunization. The medical and paramedical staffs usually ignore pain felt during these procedures. The aim of this study was to compare analgesic activity of 24% sucrose solution with breast milk during 1st DPT vaccination using sterile water as placebo. Methods: This double blind, randomized placebo controlled trial was conducted in 150 healthy infants undergoing for their 1 st DPT vaccination. Infants were randomized in to three groups of 50 each and received sterile water, 24% sucrose and breast milk 2 minutes prior to vaccination. The outcome variables were total duration of cry, first cry, change in heart rate and modified facial coding score (MFCS). Results: Mean total cry was significantly lower in 24% sucrose babies 36.3 (25.34) seconds and breast milk babies 42.1 (26.13) seconds as compared to sterile water 137.2 (20.31) seconds. Mean first cry was significantly lower in 24% sucrose 18.2 (14.12) seconds and breast milk babies 25.1 (13.67) seconds as compared to sterile water 94.3 (23.26) seconds. Mean rise in heart rate (beats/min) at 3 minutes was significantly lower with 24% sucrose 3 (2.3)and breast milk 7.4 (4.6) as compared to sterile water 18.2 (4.61).Change in MFCS at 1min and 3 min was significantly lower in 24% sucrose and breast milk babies. Maximum reduction in total cry, first cry, lower rise in heart rate and low MFCS was with 24% sucrose as compared to breast milk group. Conclusions: 24% sucrose and breast milk had analgesic activity in infants less than two months of age undergoing DPT vaccination. The analgesic effect was better for 24% sucrose as compared to breast milk.

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Section: Discussionmentioning

confidence: 99%

Comparison of analgesic effect of 24% sucrose and breast milk in healthy infants less than 2 months of age

Kavthekar

Patil

Kurane

et al. 2016

Int J Contemp Pediatr

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“…40 Numerous subsequent studies reported the same findings. [41][42][43][44][45][46][47] Calming effects were clearly nonsedating, with infants remaining alert after sucrose administration. 19 In addition, effects were observed to be sweet-taste dependent, sucrose was more effective than glucose, and the least sweet sugar, lactose, was no more effective than water in reducing crying.…”

Section: Human Model Studiesmentioning

confidence: 96%

Sucrose for Procedural Pain Management in Infants

2012

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The use of oral sucrose has been the most extensively studied pain intervention in newborn care to date. 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. 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. 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. One reason may be related to important knowledge and research gaps concerning analgesic effects of sucrose. Notably, the mechanism of sweet-taste-induced analgesia is still not precisely understood, which has implications for using research evidence in practice. 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. Pediatrics 2012;130:918-925

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“…[52][53][54][55][56][57] Kangaroo care 58,59 and breastfeeding [60][61][62][63][64] were more or equally effective, compared with sucrose alone, in most studies, with few exceptions. [65][66][67] Sucrose or glucose was equal to or more effective than eutectic mixture of topical anesthetics during heel lances, 68 finger pricks, 69 …”

Section: Additional Interventions Studiedmentioning

confidence: 99%

Analgesic Effects of Sweet-Tasting Solutions for Infants: Current State of Equipoise

et al. 2010

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OBJECTIVE: The goal was to review published studies of analgesic effects of sweet solutions, to ascertain areas with sufficient evidence of effectiveness and areas of uncertainty. METHODS: Databases searched included Medline, Embase, the Cumulative Index to Nursing and Allied Health Literature database, and PsycINFO, using the terms pain*, infant*, neonat*, newborn*, sucrose, glucose, and alternative sugars. Publications were sorted according to type, year, painful procedure studied, placebo/no-treatment groups, population studied, and country of publication. RESULTS: A total of 298 relevant unique publications involving human infants were identified; 125 (42%) were primary research studies, of which 116 (93%) were randomized controlled trials. Healthy preterm or term newborns were included in 82 studies (65%), and sick or very low birth weight infants were included in 22 (18%). Most studies included single episodes of painful procedures, with only 3 (2%) conducted over long periods. Procedures investigated most frequently were heel lance (49%), venipuncture (14%), and intramuscular injection (14%). Placebo or no-treatment groups were included in 111 studies (89%); in 103 (93%) of those studies, sweet solutions reduced behavioral responses, compared with placebo/ no treatment. CONCLUSION: Clinical equipoise relating to analgesic effects of sweet solutions no longer exists for single episodes of procedures for healthy preterm and term newborn infants. Uncertainties include outcomes after prolonged use of sweet solutions, concomitant use of other analgesics, and effectiveness beyond the newborn period. Future research should focus on addressing these knowledge and research gaps.

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The Response of Crying Newborns to Sucrose

Cited by 103 publications

References 36 publications

Comparison of analgesic effect of 24% sucrose and breast milk in healthy infants less than 2 months of age

Comparison of analgesic effect of 24% sucrose and breast milk in healthy infants less than 2 months of age

Sucrose for Procedural Pain Management in Infants

Analgesic Effects of Sweet-Tasting Solutions for Infants: Current State of Equipoise

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