Randomised trial of analgesic effects of sucrose, glucose and pacifiers in term neonates
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Giving newborn babies who undergo painful medical procedures a small amount of a sugary solution followed by a pacifier to suck (known as a dummy in the UK) can help to alleviate their distress, say authors of a study in this week's BMJ. This technique is also simple and safe and should be widely used, say the research team.
Dr Ricardo Carbajal et al from Poissy Hospital in France studied 150 new born babies and their response to pain when undergoing the routine procedure of taking blood samples (venepuncture) during their first few days of life. The research team used a recognised rating scale to ascertain "pain" in the babies, which is based on the facial expression, limb movements and vocal expression of the infant. The team then observed the individual and combined 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 pacifiers had a better analgesic effect than the sweet solutions, but that the best method of reducing pain was a combination of sucrose solution (made from sterile water mixed with sugar) followed by sucking on the pacifier. Carbajal et al suggest that the pain relief elicited by sweet solutions is probably because they activate painkillers that occur naturally in the body ("endogenous opioids"). However, the precise mechanism by which pacifiers relieve pain is unknown, say the authors. They speculate that the effect may be due to "sensory dominance" whereby the sensation elicited by sucking is so strong that it diverts their attention away from the pain or because pacifiers enhance their ability to cope with the pain because babies find sucking on a pacifier a pleasurable activity.
Carbajal et al conclude that minor procedures, such as taking blood, are common in newborns and that giving these infants an oral sweet solution followed by a pacifier to suck is a simple, non-invasive and safe method that can relieve pain. They therefore advocate that these methods be more widely used.
Contact:
Dr Ricardo Carbajal, Paediatrician, Department of Paediatrics, Poissy Hospital, France
Tel: 33-1-3927-4050/5705
Email: carbajaal@club-internet.fr