Sugar-Coating a Pacifier Helps Ease Infants' Pain

From the WebMD Archives

Dec. 2, 1999 (Atlanta) -- Sucking on a sugary pacifier can help relieve a newborn's distress during minor medical procedures like spinal taps or injections, says a study released in the current issue of the British Medical Journal.

"Treating pain in the newborn is essential," says R. Carbajal, of Poissy Hospital in France, lead author of the study. "Recent research has shown that even short-term pain can have lasting negative effects."

Neonatal specialists have developed strategies to alleviate pain caused by various diagnostic and therapeutic procedures, and general anesthesia is used in more aggressive procedures. However, says Carbajal, "It is essential to find simple, acceptable, and well-tolerated methods to reduce pain in these infants [who require minor procedures]."

The team studied 150 newborn babies and their pain response when having blood samples taken during the first few days of life. They used a recognized rating scale to determine whether the infants were in pain. The researchers then observed the effects of giving the babies oral sugar (in the form of glucose and sucrose solutions) and pacifiers -- as well as the effects of receiving neither.

They found that babies given a pacifier dipped in sucrose or glucose had "clinically significant" reductions in pain compared to those given sugar orally, the report says.

Determining whether babies are in pain is difficult, says Carbajal. Almost all previous studies have used crying as the principal tool to assess pain. "But, although closely related, crying is not unique to pain. ... We have to rely on reactions such as changes in behavior, modification in physiological variables, or release of stress hormones to infer pain ... facial expression, limb movements, and vocal expression," he adds.

Eventhough the pacifiers reduced the infants' pain, pain levels were still "relatively high," says Carbajal. "Therefore, we consider that although sweet solutions are effective in reducing pain in newborns, they are not perfect." The rapid onset of the effect strongly suggests that the simple presence of the solution in the mouth -- rather than ingestion -- was key, the authors added. Also, glucose is readily available in hospitals, whereas sucrose is not, they note.

While the authors were unsure why the sugary pacifier worked, they suspect that the "sensory dominance" of sucking may divert the infant's attention from the pain. Also, the sucking activity gives infants a sense of control.

"Minor procedures are common in newborns, and effective analgesia is seldom used in this setting," says Carbajal. Letting an infant suck on a pacifier, giving oral doses of concentrated glucose or sucrose solutions, or -- even better -- coating the pacifier with a sweet solution "constitute simple, noninvasive, and benign [methods] that can relieve pain in newborns during minor procedures," he adds. "We consider that these simple interventions are not suitable for more aggressive procedures."

Vital Information:

  • For infants undergoing minor procedures like spinal taps or injections, sucking on a pacifier coated with sugar can relieve distress better than taking sugar orally.
  • Although the sugary pacifier reduced pain significantly, the level of pain was still relatively high, so it should not be used for more aggressive procedures.
  • Researchers suggest that the sensory dominance of sucking distracts the infant's attention from the pain or the sucking activity gives the infant a sense of control.