A spoonful of sugar helps manage pain in newborns undergoing painful medical procedures

While the fictional character Mary Poppins may have been trying to charm her young wards into the unpleasant task of cleaning their room by singing 'A Spoonful of Sugar', her message apparently rings true to life.

Scientists at The Hospital for Sick Children (SickKids), the University of Toronto, Mount Sinai Hospital and York University have established that sucrose analgesia - common table sugar - can be used effectively as a treatment to manage pain in newborns undergoing painful medical procedures. This research is reported in the July 1 issue of the Canadian Medical Association Journal.

Sucrose is becoming widely used as a treatment for managing pain in newborns during medical procedures, although there has been little investigation into the effectiveness and safety of this application. While is it not fully understood how sucrose provides pain relief, SickKids Adjunct Scientist Dr. Anna Taddio and her colleagues believe that sucrose somehow activates release of the body's own natural painkillers through sweet taste.

"Studies have shown that unsatisfactory pain management in newborns can have long-term effects such as increased sensitivity to pain," says Taddio. "It is vital that we better understand both the effects of pain and how to manage it in our patients. Our research indicates that overall, sucrose is an effective and safe pain management option."

The study involved 240 babies no more than two days old, half whose mothers are diabetic. The babies were treated with either a placebo or a sucrose solution prior to all painful medical procedures routinely performed on babies, including venipuncture (drawing blood with a needle), heel-lance and intramuscular injection. The scientists measured pain by evaluating facial expressions and physiological responses of infants.

Diabetic mothers were included in the study because their babies are treated differently at birth, receiving additional heel-lance procedures to monitor their glucose levels. And while it has also been thought that the use of sucrose for diabetic offspring could elevate their blood glucose level, this study showed no adverse effects resulting from the sucrose solution.

Results demonstrated a modest decrease in the level of pain experienced by the newborns who received the sucrose treatment. Analyzing the procedures separately, researchers found that sucrose is only effective for managing pain caused by venipuncture. According to Taddio, "More work is needed to identify strategies that will eliminate pain completely."

This study was supported by the Canadian Institutes of Health Research (CIHR) and the SickKids Foundation.

The Hospital for Sick Children (SickKids), affiliated with the University of Toronto, is Canada's most research-intensive hospital and the largest centre dedicated to improving children's health in the country. As innovators in child health, SickKids improves the health of children by integrating care, research and teaching. Our vision is Healthier Children. A Better World. Our mission is to provide the best in complex and specialized care by creating scientific and clinical advancements, sharing our knowledge and expertise and championing the development of an accessible, comprehensive and sustainable child health system.