Sucrose proven effective for pain relief in newborns

Investigators have identified pain relief from sucrose in newborns during common hospital procedures such as venipuncture, publishing their findings in Cochrane Database of Systematic Reviews.¹

Improvements in pain were found from sucrose compared with no treatment, water, and standard care, Additionally, sucrose was found to be even more effective when combined with non-nutritive sucking (NNS).¹

“The evidence shows that a small amount of sucrose given just before the procedure is a simple, fast and effective way to reduce… pain,” said Mariana Bueno, PhD, RN, assistant professor at the University of Toronto. “Our review helps clinicians use this evidence more confidently and consistently in practice.”¹

Evaluating pain intensity

The study was conducted to determine the harms and benefits of an oral sucrose provision for pain relief in preterm and term neonates undergoing venipuncture.² Data was obtained through searches of the MEDLINE, CENTRAL, Ovid Embase, and trial registries databases in July 2025.

Randomized controlled trials (RCTs) assessing outcomes following sucrose analgesia for venipuncture in neonates up to 44 weeks’ postmenstrual age were eligible for the analysis. Quasi-RCTs and studies only reported as conference abstracts were excluded. There were no limits on the concentration, volume, or dose of sucrose.²

Pain intensity scores, validated pain assessment scores, and adverse events were reported as primary outcomes. These outcomes were compared between sucrose, water, and standard care, the latter of which included skin-to-skin care, breastfeeding, feeding, NNS alone, glucose, positioning, and topical anesthetics.²

Risk ratios (RRs) were calculated with 95% confidence intervals (CIs). Additionally, investigators calculated the standardized mean difference (SMD) or mean difference (MD) for pain intensity scores with the 95% CI.²

Analysis of sucrose administration

Twenty-nine studies with 2764 preterm and term neonates were included in the final analysis. Across these studies, the sucrose dose provided ranged from 0.1 mL/kg to 0.5 mL/kg or was provided at a set volume ranging from 0.1 mL to 2 mL.²

The mode of administration also differed between studies and included oral, syringe, pacifier, dropper, and in combination with pacifier. Of the studies, 17 compared sucrose outcomes to no intervention, water, or standard care.²

When compared to no intervention, sucrose was associated with a significant reduction in pain intensity scores during and 30 seconds after venipuncture, with an SMD of -0.82. Additionally, an MD of -9.15 was reported for reduced pain after 1 minute when providing sucrose alongside NNS vs no intervention, highlighting a significant reduction.²

The evidence for sucrose without NNS 2 minutes after venipuncture vs standard care was very low certainty. Additionally, little to no difference in pain was reported for sucrose without NNS on pain scores during venipuncture when compared with skin-to-skin contact, with an MD of 1.49.²

Additional findings and clinical recommendations

When measuring pain scores during venipuncture with the Neonatal Facial Coding System, sucrose was linked to a significant reduction in pain vs breastfeeding, with an RR of 1.38. However, the RR was 1.06 at 2 minutes after venipuncture, indicating little to no difference in pain.²

Compared to NNS alone, a combination of sucrose and NNS had an SMD of -1.52 for reduced pain during venipuncture, indicated reduced pain. However, no significant reduction was found for sucrose alone vs NNS alone, with an MD of 1.37. Overall, sucrose was linked to multiple instances of reduced pain during venipuncture in newborns.²

“To ensure safety and clinical consistency, sucrose must be administered under formal medication protocols that define specific timing and dosage for painful procedures,” said Jiale Hu, PhD, RN, associate professor at Virginia Commonwealth University.¹

References

1. Sugar comforts newborn babies during painful procedures. Cochrane. March 3, 2026. Accessed March 4, 2026. https://www.eurekalert.org/news-releases/1117421?
2. Bueno M, Candido L, Hu J, et al. Sucrose analgesia for venepuncture in neonates. Cochrane Database of Systematic Reviews. 2026. doi:10.1002/14651858.CD015221.pub2