A recent Cochrane review has found that sucrose, a simple sugar solution, can help reduce pain in newborn babies during hospital procedures involving needles, such as blood draws. These procedures are common for both preterm and full-term infants, especially those in neonatal intensive care units (NICUs), who often undergo numerous interventions due to their medical needs.
Newborns have underdeveloped systems for regulating pain and may experience these procedures intensely. Untreated procedural pain has been linked to poorer physical growth and possible impacts on brain development later in life. Because of this, effective and accessible methods for managing pain are important.
Sucrose has been used for decades as a low-cost method of relieving pain in infants by placing a small amount of the sweet solution in the baby's mouth before needle procedures. Despite recommendations in various clinical guidelines, the use of sucrose remains inconsistent across hospitals.
The new review analyzed 29 clinical trials with over 2,700 infants who underwent venepuncture while hospitalized. It found that sucrose probably reduces pain both during and immediately after needle procedures compared to no treatment, water, or standard care. The effect appears stronger when sucrose is combined with non-nutritive sucking—such as giving the baby 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 lead author Mariana Bueno from 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 use this evidence more confidently and consistently in practice."
None of the studies included reported immediate side effects from using sucrose in the small amounts needed for procedural pain relief. However, most research focused only on short-term outcomes; further study is required to understand potential long-term effects when used repeatedly over extended periods.
"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," said co-author Ligyana Candido from the University of Ottawa. "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."
Researchers observed significant variation among hospitals regarding how sucrose was administered—including differences in dosage and timing—which could affect its effectiveness.
"What stood out to me when doing this review was the wide variation in how sucrose was given to newborns," Bueno added. The authors believe their findings could help inform clearer protocols so clinical practice becomes more consistent.
They emphasize that sucrose should be reserved specifically for painful procedures rather than being given routinely just to calm crying babies.
"To ensure safety and clinical consistency, sucrose must be administered under formal medication protocols that define specific timing and dosage for painful procedures," said co-author Jiale Hu from Virginia Commonwealth University.
The authors suggest future research should compare comfort measures like skin-to-skin contact, breastfeeding, and sucrose directly with each other instead of comparing them only against no treatment. They also recommend further study into any possible long-term consequences from repeated use among babies spending prolonged periods in neonatal care.
