Mariana Bueno, PhD, RN, discusses how sucrose manages newborn pain

In this interview with Contemporary Pediatrics, Mariana Bueno, PhD, RN, discusses the crucial role of sucrose in managing procedural pain for preterm infants in neonatal intensive care units, highlighting the challenges, concerns, and strategies for its effective implementation.

Addressing physiological and developmental concerns, Bueno notes that while repetitive, untreated pain is known to be detrimental to an infant’s growth and development, the long-term neurodevelopmental effects of repeated sucrose administration remain underresearched. Current studies indicate that repeated sucrose use during the neonatal period does not cause developmental delays, though it is still unclear to what extent it actively mitigates the adverse effects of early-life pain. Consequently, Bueno emphasizes the need to use local protocols, treat sucrose strictly as a medication, and ensure proper documentation and clinical reasoning for its administration.

Bueno also identifies several significant clinical barriers to the consistent use of sucrose. Primarily, resistance to changing entrenched practices poses a challenge. Additionally, sucrose is often not readily available at the bedside; in a fast-paced clinical environment, health care professionals may opt to bypass it rather than wait. Furthermore, clinicians frequently underestimate the cumulative impact of minor painful procedures, such as quick needle pokes, mistakenly believing that brief interventions do not warrant analgesia.

To overcome these institutional barriers, Bueno recommends ensuring that sucrose is always accessible, establishing clear guidelines and integrating its use into structured daily workflows. She also suggests appointing clinical “champions” to drive education and actively engaging parents in their child’s pain care.

When considering long-term care strategies, Bueno stresses the importance of recognizing all invasive procedures as inherently painful. Pain management interventions should be evidence based, safe, and highly individualized, taking into account the infant’s clinical status, gestational age, and family readiness. Clinicians must be well versed in these strategies and consistently apply established protocols to prevent and minimize procedural pain.

Finally, Bueno highlights a fundamental ongoing challenge: the absence of a gold-standard pain assessment tool for neonates, which forces a reliance on clinician observation and published secondary assessment measures. Above all, she asserts a core principle: If a procedure is painful for an older child or adult, it is equally painful for a baby.

Therefore, clinicians must adopt a preemptive approach, administering pain relief before the infant exhibits clear signs of distress. Implementing these preventive measures is vital to protecting infants from the long-term adverse consequences of pain extending into later life and adulthood.

This video is part 2 of a 2-part series. Click here for part 1.

No relevant disclosures.

Reference

Sugar comforts newborn babies during painful procedures. Cochrane. March 3, 2026. Accessed March 9, 2026. https://www.eurekalert.org/news-releases/1117421?