REVIEW ARTICLE

Sucrose for Procedural Pain Management in Infants

AUTHORS: Denise Harrison, RN, RM, PhD,a,b,c,d Simon
Beggs, PhD,e,f and Bonnie Stevens, RN, PhDg,h,i abstract
aCentre for Practice Changing Research, Children’s Hospital of The use of oral sucrose has been the most extensively studied pain
Eastern Ontario, Ottawa, Canada; bSchool of Nursing, Faculty of
Health Sciences, University of Ottawa, Ottawa, Canada; cMurdoch
intervention in newborn care to date. More than 150 published stud-
Childrens Research Institute, Parkville, Australia; dThe University ies relating to sweet-taste-induced calming and analgesia in human
of Melbourne Faculty of Medicine, Dentistry and Health Sciences, infants have been identified, of which 100 (65%) include sucrose. With
Melbourne, Australia; eProgram in Neurosciences & Mental
only a few exceptions, sucrose, glucose, or other sweet solutions
Health, Hospital for Sick Children, Toronto, Canada; fFaculty of
Dentistry, University of Toronto, Toronto, Canada; gLawrence S. reduced pain responses during commonly performed painful proce-
Bloomberg Faculty of Nursing and Faculty of Medicine, and dures in diverse populations of infants up to 12 months of age.
hUniversity of Toronto Centre for the Study of Pain, University of
Sucrose has been widely recommended for routine use during painful
Toronto, Toronto, Canada; and iSenior Scientist Research
Institute, The Hospital for Sick Children Toronto, Canada procedures in newborn and young infants, yet these recommenda-
KEY WORDS
tions have not been translated into consistent use in clinical practice.
pain, infant, neonate, sucrose, analgesia One reason may be related to important knowledge and research
ABBREVIATIONS gaps concerning analgesic effects of sucrose. Notably, the mechanism
CNS—central nervous system of sweet-taste-induced analgesia is still not precisely understood,
NNS—nonnutritive sucking which has implications for using research evidence in practice. The
PIPP—Premature Infant Pain Profile
RCT—randomized controlled trial aim of this article is to review what is known about the mechanisms
www.pediatrics.org/cgi/doi/10.1542/peds.2011-3848
of sucrose-induced analgesia; highlight existing evidence, knowledge
gaps, and current controversies; and provide directions for future
doi:10.1542/peds.2011-3848
research and practice. Pediatrics 2012;130:1–8
Accepted for publication Jun 21, 2012
Address correspondence to Denise Harrison, RN, RM, PhD, 3rd
Floor RGN Building, School of Nursing, Faculty of Health Sciences,
401 Smyth Rd, Ottawa, Ontario, Canada K1H 8L1. E-mail: denise.
harrison@uottawa.ca
PEDIATRICS (ISSN Numbers: Print, 0031-4005; Online, 1098-4275).
Copyright © 2012 by the American Academy of Pediatrics
FINANCIAL DISCLOSURE: The authors have indicated they have
no financial relationships relevant to this article to disclose.

(Continued on last page)

PEDIATRICS Volume 130, Number 5, November 2012 1

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The use of oral sucrose has been the
most extensively studied pain in-
tervention in newborn care to date.
More than 150 published studies re-
lating to sweet-taste-induced calming
and analgesia in human infants have
been identified, of which 100 (65%) in-
clude sucrose. With only a few excep-
tions, 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.1–3 Su-
crose has been widely recommended
for routine use during painful proce-
dures in newborn and young infants,4–10
yet these recommendations have not
been translated into consistent use in
clinical practice.11–13 One reason may be
related to important knowledge and re-
search gaps concerning analgesic
effects of sucrose. Notably, the mecha-
nism 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 mech-
anisms of sucrose-induced analgesia;
highlight existing evidence, knowledge
gaps, and current controversies; and
provide directions for future research
and practice.
HISTORICAL OVERVIEW
Oral sucrose has been the most ex-
tensively studied procedure-related
pain reduction strategy in neonatal
care.1,3 Although randomized con-
trolled trials (RCTs) evaluating effects
of sucrose in infants were not pub-
lished until the late 1980s, there are
historical references pertaining to the
analgesic and calming benefits of
sweet substances dating back to AD 632,
when Prophet Mohammed recom-
mended giving infants a well-chewed
date.14 Sugar solutions, often mixed
with a combination of alcohol and co-
caine or opium, were widely promoted
in the late 1840s and early 1900s as an
2 HARRISON et al
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effective intervention to calm crying
infants, alleviate colic pain, and reduce
pain during procedures in young chil-
dren.15,16 Sugar mixed with wine or
whisky was recommended for infant
boys undergoing circumcision,17 and in
1938, recommendations were made
that suggested anesthesia for infants
during surgery was often not required
and that “a sucker consisting of
a sponge dipped in some sugar water
will often suffice to calm a baby”
(p. 2021).18
Language used to describe the effects of
sucrose on infants from these early
reports through to present-day studies
varies from report to report. Terms
such as “calming” and “analgesic” are
frequently used interchangeably. Anal-
gesia reduces behavioral and phys-
iologic indicators of pain. Calming
reduces observable behavioral indica-
tors of pain and distress. The indica-
tors for analgesia and calming are
highly intertwined, making it difficult to
discriminate between them. This is
true as well for studies of sucrose using
animal models. However, for the pur-
poses of this article, the interpretation
of these terms are as follows.
“Calm” was defined by Blass and
Ciaramitaro in 1994 as an alert yet
quiet state; “when infants cried less
than 24 sec/min during the 10 min that
preceded stimulation and were in an
alert state as judged by eye opening
and gross motor activity scores of ap-
proximately 0.5 or more” (p. 40).19 Calm
is most commonly used to describe an
alert and quiet, but not sedated state.
“Analgesia” is defined by the In-
ternational Association for the Study of
Pain as the absence of pain in response
to stimulation that would normally be
painful20 and “pain” is defined as “An
unpleasant sensory and emotional ex-
perience associated with actual or
potential tissue damage, or described
in terms of such damage. Note: The
inability to communicate verbally does
not negate the possibility that an in-
dividual is experiencing pain and is in
need of appropriate pain-relieving treat-
ment. Pain is always subjective.”20
This use of the term analgesia, defined
by the International Association for the
Study of Pain, is particularly open to
criticism when describing effects of
most analgesic agents. “Absence of
pain,” based on observational mea-
sures (behavioral indicators including
facial expressions, crying, body move-
ments) and composite measures (be-
havioral and physiologic indicators
plus other indicators such as behav-
ioral state, nurses perception of pain)
is rarely achieved, yet the term is
widely used in neonatal pain studies.
This, highlights the subjective nature
and selection of terms and the lack of
clarity surrounding the term “pain”
in infants among clinicians and re-
searchers. In addition, the emotional
component of pain in infants is not able
to be interpreted. Despite many years
of debate,21 this lack of clarity of the
definition and meaning of these terms
still has an impact on the inter-
pretation of infants’ responses to
sucrose, especially because the mecha-
nisms of sucrose are not fully un-
derstood in either animals or humans.
ANIMAL MODEL STUDIES
Investigations into the cellular and
molecular mechanisms underlying the
effects of sucrose in animal models are
relatively sparse and hampered by
varying methodologies. However, there
is compelling evidence that an endog-
enous opioid-sweet taste relationship
exists.22–31 Calming and/or analgesic
effects of sucrose that occur rapidly,
last for several minutes, and can be
blocked by systemic opioid receptor
antagonists have been demonstrated
in rats.29,32 The mechanism of effects
suggest an increase in serum and ce-
rebrospinal fluid b-endorphin levels
after orally ingested sucrose but not

intragastrically administered sucrose.31
However, as in human infants, the liter-
ature is confounded in part by the
difficulty in distinguishing between a
calming and pain-relieving effect33 (ie,
separation of stress from nociceptive
responses).
There are few firm conclusions to be
drawn from the animal literature on the
mechanism of sucrose. Variability in
age of animals, modality of testing,
sucrose dose, and timing of adminis-
tration makes direct comparison be-
tween studies difficult. Using c-fos as
a surrogate of neural activity combined
with behavioral testing, Anseloni and
colleagues showed an age-dependent
analgesic action of sucrose in rat
pups.32 Noxious activation of spinal c-fos,
was significantly reduced with su-
crose. Using reflex withdrawal thresh-
olds to a noxious stimulus, Anseloni
and colleagues demonstrated a post-
natal window of efficacy of sucrose
restricted to the first 2 or 3 weeks of
life and also a clear rostrocaudal de-
velopmental gradient of this effect,
with a delayed effect of sucrose on
hind-paw responses compared with
forepaw.
Considerable postnatal development
occurs in central nervous system (CNS)
structures involved in both nociception
and opiate-receptor-dependent modu-
lation of nociceptive input,34–36 which
accounts for these changing sucrose
responses in animals. In another study,
to elucidate the central pathways that
mediate the effects of sucrose, Anse-
loni and colleagues again used c-fos
activity in CNS neurons and behav-
ioral reflex responses to probe into
higher centers of the CNS.37 Through
the use of midcollicular lesions, they
were able to isolate higher centers (eg,
the forebrain), and show that sucrose
persisted in attenuating the behavioral
nociceptive responses in the rat pups,
indicating that forebrain circuitry is
not required for the activity of sucrose.
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Furthermore, using c-fos expression,
they were able to map sucrose-induced
activity in the CNS and showed that the
solitary tract in the brainstem was
activated. Because this is the primary
relay in the ascending gustatory path-
way, it is not surprising that there is
activity after intraoral sucrose in ani-
mals. However, they also found evi-
dence of activity in brainstem areas
associated with descending pain mod-
ulation, the periaqueductal gray, and
raphe nucleus.37 The medullary raphe
nucleus is a critical mediator of en-
dogenous analgesia and modulates the
analgesic actions of opioids.38 Fur-
thermore, the ingestion of hedonic
foodstuffs (eg, sucrose) is associated
with analgesia.39 This effect has been
proposed to be a consequence of sup-
pressed reactions to distracting (ie,
painful) stimuli mediated by the raphe
nucleus.39 In the adult rat model, the
brainstem-spinal cord projections are
an important source of nociceptive
processing in the spinal cord. In the
neonate, however, the descending in-
hibitory influences are not fully ma-
ture,34,35 and descending inhibitory
tone can only be detected after the
third postnatal week in rats.35,36 As
such, the influence of oral sucrose on
these structures and central nocicep-
tive processing is unclear and requires
further elucidation. Both the ascending
gustatory and associated descending
pathways are known to have an opioid-
receptor-mediated modulated compo-
nent, but where specifically within this
pathway the antagonistic effects of
opioid blockade on oral sucrose effects
occurs is unclear.
HUMAN MODEL STUDIES
While the role of sucrose in reducing
pain and stress in animal models was
being studied, effects in human infants
were also being evaluated. In 1989,
Blass and colleagues first reported that
sucrose was extraordinarily calming
REVIEW ARTICLE
with effects persisting well beyond the
initial sucrose dose.40 Numerous sub-
sequent studies reported the same
findings.41–47 Calming effects were
clearly nonsedating, with infants re-
maining alert after sucrose adminis-
tration.19 In addition, effects were
observed to be sweet-taste dependent,
sucrose was more effective than glu-
cose, and the least sweet sugar, lac-
tose, was no more effective than water
in reducing crying. To further test the
endogenous opioid basis of sweet-
taste-induced calming, the response
of sucrose in infants born to mothers
on methadone was evaluated.19 Be-
cause infants exposed to antenatal
methadone have a poorly functioning
endogenous opioid system, it was
hypothesized that the sweet-taste-
mediated analgesic mechanism would
not function in these infants.19 Findings
supported the hypothesis-, sucrose was
ineffective in calming methadone ex-
posed infants suffering from withdrawal
symptoms, adding evidence to the as-
sociation among sweet taste, an intact
endogenous opioid system, and analge-
sia. Until recently, this was the only study
examining effects of sucrose in infants
with antenatal opioid exposure.
From these studies demonstrating
calming effects of sucrose on crying
infants, the research questions turned
to whether sucrose reduced pain if
given before painful procedures. In
the first published report of a placebo-
controlled RCT of sucrose for procedural
pain in newborn infants, sucrose sig-
nificantly reduced crying during a heel
lance and resulted in a more rapid
return to a calm state compared to
water.48 Additionally, the combination
of 24% sucrose solution and non-
nutritive sucking (NNS) significantly
reduced crying duration during cir-
cumcision, compared with no treat-
ment or NNS with water.48
The compelling evidence from these
early studies demonstrating profound
3
effects of oral sucrose in inducing and
maintaining a calm yet awake state in
newborn infants and reducing behav-
ioral responses during painful proce-
dures compared with water and less
sweet solutions, set the stage for an
abundance of subsequent studies,
reviews, and systematic reviews.1,3 A
systematic review and meta-analysis of
44 RCTs showed that sucrose consis-
tently reduced behavioral responses
(cry duration, facial actions, and com-
posite pain scores (consisting of be-
havioral and physiologic indicators) to
tissue-damaging noxious procedures
compared with placebo, no treatment,
or less sweet solutions including
breast milk.3 An exception to these
findings was when sucrose had mini-
mal effects compared with water when
given within hours of birth before in-
tramuscular injection of vitamin K.49
This finding concurred with an animal
model study in which sucrose had no
effect in reducing responses to ther-
mal stimuli in newborn rats on the first
day of life.32 One explanation proposed
for this more modest effect of sweet
taste in the first 12 hours of birth may
be due to high circulating serum b
endorphins negating further increase
in response to sweet taste.50
Sucrose has also beenshown to be less
effective when used for prolonged and/
or more intensely painful procedures.
Although results of a meta-analysis of 4
studies conducted during eye exami-
nation showed sucrose significantly
reduced Premature Infant Pain Profile
(PIPP) scores, the effects were small
and inconsistent between individual
studies.51–54 In addition, a 50% glucose
solution was no more effective than
water during circumcision,55 and
a single dose of sucrose failed to sig-
nificantly reduce crying in older infants
undergoing urethral catheterization56
and venepuncture.57 The reduced ef-
fectiveness of sweet solutions in these
more invasive procedures of relatively
4 HARRISON et al
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long duration may be due to the short-
lasting effects of a single dose given 2
minutes before the procedures. Effects
may not be sustained over prolonged
procedures, especially in infants be-
yond the newborn period.1 Although
the duration of sucrose for $5 minutes
in healthy newborn infants has been
demonstrated, 40,41,58,59 and in one
study, a prolonged effect time up to 45
minutes in healthy newborns was
reported,59 a short effect time of only 1
minute was demonstrated in infants
aged 5 to 7 weeks.41 Based on these
observations, administering sucrose in
small aliquots throughout the duration
of painful procedures of prolonged
duration may ensure a more sustained
analgesic effect.2
Despite the strong evidential base of
analgesic effects of sucrose in newborn
and young infants for single painful
procedures,1 there remain knowledge
gaps concerning the following:
 Opioid pathways involved in mech-
anism of effect, especially in the
developing infant
 Effectiveness when administered
with concomitant opioid analgesics
 Effectiveness when administered
concurrently with other pain man-
agement strategies such as skin-
to-skin care
 Use, safety, and effectiveness when
used repeatedly for extended peri-
ods in extremely low birth weight
infants and sick infants requiring
prolonged hospitalization
Despite the extensive work conducted
in animal laboratories from the 1980s
onward, the mechanisms of analgesic
effects of sweet solutions in human
infants remain poorly understood. On
the basis of animal studies, the key
mechanism is believed to be sweet-
taste-induced b-endorphin release.22,31
However, elevated serum levels of
b-endorphin in response to oral
sucrose has not been identified in
human infants to date.60 In addition,
other central mechanisms of sucrose
including dopamine and acetylcholine
have been postulated.61 Additional
research is required to elucidate their
role in pain reducing effects of sucrose.
The limited understanding of sucrose
mechanisms has also had an impact on
the interpretation of nonbehavioral
responses that are not attenuated by
sucrose solutions. As highlighted in the
systematic review of sucrose for anal-
gesia in newborn infants undergoing
painful procedures,3 sucrose reduced
behavioral responses and various
composite pain measures during sin-
gle episodes of short, sharp, painful
procedures compared with no treat-
ment, water, NNS, and small volumes of
breast or formula milk. However, when
examined in isolation, responses other
than behavioral were less consistently
attenuated by sucrose. Oxygen satura-
tion during heel lance or venipuncture
was not influenced by oral sucrose,
and sucrose reduced heart rate
changes from baseline in only half of
the studies.3 Similarly, cortical activity,
as measured by EEG responses are
inconsistent with behavioral respon-
ses.62,63 No differences in EEG respon-
ses during heel lance between sucrose
and water (measured ,1 second after
heel lance)63 or glucose and water
(averaged over 2 minutes after heel
lance)62 were demonstrated despite
significant reduction in PIPP scores.
In addition, hormonal responses as
measured by salivary cortisol were not
affected by sucrose administration
during heel lance, circumcision, or all
painful procedures during the first
week of life in a NICU.3 These studies
highlight important questions about
the mechanisms of sweet-taste-
mediated pain reducing responses, in
particular, the inconsistency among
behavioral, physiologic, hormonal,
and cortical responses. In infants, the
correlation between physiologic and

behavioral responses to pain is repor-
ted be only 0.3.64 The dissociation, di-
rection, and degree of responses is
common among all types of pain indi-
cators across all ages, illustrating the
complexity of the responses to noci-
ceptive stimuli and the subjective
phenomenon of pain.64 Given this
complexity and weak correlation
among various types of indicators,
the ongoing, fundamental question
remains whether there is an optimal
indicator(s) of pain and what it might
be in infants. The dissociation among
behavioral, physiologic, and cortical
responses illustrates that 1 pain out-
come or 1 indicator of pain does not
sufficiently capture the complete pic-
ture of pain.
Another key unanswered question is to
what extent the sweet-taste-mediated
endogenous opioid effects occur in
the context of exogenous opioid de-
livery. Whether sucrose reduces pain
when given with concomitant opioid
analgesics is an important question
because the effectiveness of opioid
analgesics alone in reducing pain in
sick infants during acute painful pro-
cedures is questionable.65–69 Sucrose
given with exogenous opioid analge-
sics has only been evaluated in 2
studies.70,71 Harrison et al72 reported
no statistically significant differences
in behavioral responses during heel
lance when infants were receiving
opioid analgesics and sucrose com-
pared with receiving sucrose alone.70
However the number of observations
when infants were receiving opioid
analgesics (n = 79) may have been
underpowered to detect a difference.
Second, Marceau et al evaluated 24%
sucrose during heel lance in newborn
infants born to mothers on antenatal
methadone, compared with non-
methadone exposed infants.71 Eight of
the 26 methadone-exposed infants
were receiving morphine at the time
of study for management of opioid
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withdrawal. No group differences in
PIPP scores, heart rate, or oxygen sat-
uration were reported. In fact, PIPP
scores across all infants were all low,
suggesting efficacy of sucrose even in
the context of methadone exposure and
withdrawal. The study had a number of
limitations due to unblinding, and the
small sample size of infants receiving
morphine (n = 8 infants). Given the in-
consistency of results with the only
previous study evaluating sucrose for
methadone exposed infants,19 more
research in this area is warranted.
The previously established evidence
regarding the ability of opioid antago-
nists to block analgesic effects of sweet
solutions has also been called into
question. Although in animal models,
naloxone blocked analgesic effects of
sucrose,32 this same effect was not
demonstrated in human newborn
infants when naloxone was injected
intravenously.73 In fact, the opposite
effect occurred; analgesic effects of
naloxone were demonstrated. Such
analgesic effects of opioid antagonists
when given in low doses have been
reported previously.74 However, such
conflicting results emphasize uncer-
tainties as to the mechanism of su-
crose analgesia, the opioid pathways
responsible, as well as the differences
between animal and human infant
mechanisms precluding consistent ap-
plication of bench to bedside findings.
Although there is a plethora of pub-
lished studies evaluating sucrose
during single episodes of painful pro-
cedures,1,3 knowledge gaps concerning
the effectiveness and safety of multiple
doses given during varying frequen-
cies over the course of an infant’s hos-
pitalization remain. Prolonged use of
sucrose for periods of .1 weeks’ dura-
tion, during repeated painful events has
been reported in only 3 studies: 2 RCTs in
preterm infants75,76 and a longitudinal
cohort study of infants hospitalized
between 1 and 5 months, all of whom
REVIEW ARTICLE
received sucrose during heel lance.72
Both RCTs showed that sucrose was
more effective than NNS alone or
standard care,75,76 and sucrose alone
was more effective than NNS and topi-
cal anesthetic during repeated sub-
cutaneous injections, although the
combination of all 3 interventions had
the largest effect.76 Harrison et al72
reported that behavioral indicators of
pain remained persistently low with no
increase in these parameters over the
full course of infants’ hospitalization.
In addition, changes in physiologic
parameters in response to heel lance
remained stable over the course of
hospitalization. To date, these are the
only studies examining prolonged use
of sweet solutions for procedural pain
management.
Prolonged use of sucrose raises im-
portant questions related to effective-
ness and safety, although there is
a paucity of data relating to long-term
outcomes. Johnston et al reported
that preterm infants ,31 weeks’ ges-
tational age who received .10 doses
of sucrose per 24 hours in the first
week of life had poorer neurologic
outcomes compared with infants who
received fewer sucrose doses.77 No
differences in any safety outcomes af-
ter consistent use of sucrose for pre-
term infants over the first month of life
were reported in another study.75
These are the only studies that have
reported on longer-term outcomes in
infants after repeated sucrose use.
PRACTICE AND RESEARCH
IMPLICATIONS
The complexities in interpreting such
a diverse body of evidence relating to
the role of sucrose in inducing calm and
reducing pain responses, the prevailing
deficiencies in understanding mecha-
nisms involved in sucrose analgesia,
and the dearth of evidence relating to
extended and repeated use of sucrose
in preterm and sick infants have
5
resulted in debates and controversy
over whether sucrose should be con-
sidered standard care.1,61,63 The same
argument applies to glucose, because
many studies have shown that glu-
cose, if sufficiently concentrated, also
reduces pain in infants.1,78,79 However,
although basic science and clinical
researchers and clinicians continue to
address the knowledge and research
gaps relating to analgesic effects and
mechanisms of sucrose, we need to
remain cognizant that untreated or
poorly treated pain in fragile infants
has well-documented short-term ad-
verse consequences and potential
longer-term negative effects.4 Clini-
cians therefore have an ethical re-
sponsibility to minimize pain exposure;
use sucrose appropriately for single
painful procedures, along with other
evidence-based strategies including
NNS, kangaroo care, and breastfeeding
when feasible;80 and monitor use and
effectiveness of these strategies over
short- and long-term periods. Impor-
tantly, clinicians’ decisions must be
based on the best evidence available
and not swayed by single studies or
pervasive myths.81 Clinicians and
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2. Harrison D, Stevens B, Bueno M, et al. Efficacy
of sweet solutions for analgesia in infants
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researchers would, however, benefit
from clear guidelines including rec-
ommended volumes and dosing regi-
mens of sucrose. Although the authors
of the Cochrane systematic review of
sucrose analgesia in newborn infants
could not establish an optimal sucrose
dose,3 only small volumes are re-
quired, such as 0.1 to 1 mL or ∼0.2 to
0.5 mL/kg. Researchers and clinicians
should take into account tailoring
doses based on context in which su-
crose is to be used, including gesta-
tional and postnatal age of the infant,
severity of illness, and the painful
procedure being performed. Finally,
a consensus on the definition of “pain”
in infants may greatly assist pain
researchers to use consistent terms
and to use consistent outcome mea-
surements in future studies. Remaining
knowledge and research gaps concern
the mechanism of the effects of su-
crose, determination of the best in-
dicator or combination of indicators
for assessing pain in infants, effec-
tiveness and safety for repeated use
in extremely preterm infants and
critically ill infants, effectiveness
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Health Nurs. 2006;9:27–29
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methadone or receiving postnatal
opioid analgesics, and best dosing
regimes.
CONCLUSIONS
Prolific research concerning pain-
reducing properties of sucrose has
been conducted over the past 25 years,
with indisputable evidence that small
volumes significantly reduce behav-
ioral responses and composite pain
scores to painful procedures in new-
born and young infants. Recom-
mendations for practice include using
small volumes of sucrose for painful
procedures only; avoiding use for
calming irritable infants who are not
undergoing procedures; giving sol-
utions in aliquots over the duration of
the procedure for prolonged proce-
dures; avoiding use of .10 doses per
24 hours, especially during the first
week of life; and using other effective
strategies during painful procedures
when feasible. Future research needs
to address remaining areas of uncer-
tainty with the ultimate aim of ensuring
that no infant suffers unnecessary pain
during painful procedures.
9. Spence K, Henderson-Smart D, New K,
Evans C, Whitelaw J, Woolnough R; Aus-
tralian and New Zealand Neonatal Net-
work. Evidenced-based clinical practice
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(Continued from first page)

FUNDING: Dr Harrison is the holder of the Children’s Hospital of Eastern Ontario (CHEO) Chair in Nursing Care of Children, Youth and Families at CHEO and the
University of Ottawa. Dr Harrison was supported as a postdoctoral fellow by the Pain in Child Health Strategic Training Initiative (grant STP53885) and Canadian
Institutes of Health Research Team Grant in Children’s Pain (grants CTP-79854 and MOP-86605) (36,750/year) for 2 years from 2008 to 2010. Dr Harrison also
received grants from CHEO Research Institute for an operating grant for a pilot study titled “Be Sweet to Toddlers During Needles” and 2 summer studentship
grants in 2011 and 2012; a CHEO and Faculty of Health Sciences, University of Ottawa Partnership Grant titled “Be Sweet to Sick Babies: Analgesic Effects of Oral
Sucrose and Concomitant Opioid Analgesics: A Pilot Randomized Controlled Trial”; Canadian Institutes of Health Research (CIHR) Café Scientifique grant titled “Be
Sweet and Safe to Children and Youth During Pokes and Pains”; and a Nurses Board of Victoria, Australia, major research grant titled “Be Sweet to Babies During
Immunization.” Dr Stevens is supported through the Signy Hildur Eaton Chair in Paediatric Nursing. Dr Stevens is the principal investigator on a CIHR operating
grant titled “Pain in Infants at Risk for Neurological Impairment: Phase 3” and a CIHR Team Grant in Children’s Pain (grants CTP-79854, MOP-86605 and MOP-231330).

8 HARRISON et al
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 Sucrose for Procedural Pain Management in Infants
Denise Harrison, Simon Beggs and Bonnie Stevens
Pediatrics originally published online October 8, 2012;

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 Sucrose for Procedural Pain Management in Infants
Denise Harrison, Simon Beggs and Bonnie Stevens
Pediatrics originally published online October 8, 2012;

The online version of this article, along with updated information and services, is
located on the World Wide Web at:
http://pediatrics.aappublications.org/content/early/2012/10/02/peds.2011-3848

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