While a spoonful of sugar helps the medicine go down, a new study shows it may also ease the pain of vaccinations in infants.
According to study author Linda Hatfield, PhD, an assistant professor of public health services at the Pennsylvania State University School of Nursing in University Park, this paper is one of the first to study infants who have already left the hospital. Most previous studies were done on preterm newborns who, by circumstance, receive more shots.
Background
The annual immunization schedule for healthy new arrivals in this world is daunting; infants and toddlers receive as many as 24 injections in the first two years of life. As many as five injections can be given to a child in a single visit.
But many parents are petrified at the prospect of seeing their child in pain.
"Some mothers say they've never heard their baby cry like that," Dr. Hatfield said. "They're reluctant to bring their sweet little children in."
There's also some indication that exposure to pain early in life might have long-term neurological effects.
The Study
Dr. Hatfield and her colleagues randomized 100 two- and four-month-old infants to receive either oral sucrose or a placebo (sterile water) two minutes before routine immunizations.
Pain was assessed with a score that took into account crying, facial expression, body movement, behavioral indications and sleep.
Parents were asked not to swaddle or cuddle their child during the immunization as this could have had an effect on the experience of pain.
Results
The sucrose group showed lower pain scores at five, seven and nine minutes after being given the solution and, by nine minutes, had a mean pain score 785% lower than that of the placebo group.
Theory
Previous research has suggested a link between exposure to sucrose and release of the body's natural pain-relieving chemicals.
Implications
Is it a good idea to give sugar to young babies? Dr. Hatfield says the solution is so weak (only one-quarter sugar) that it's unlikely to have any effect on later weight problems and doesn't even raise blood sugar in the short-term.
And experts are hoping that a simple sugar-and-water solution will also ease parents' fears and boost immunization rates for infants.
"We're hoping this will encourage parents to get their children vaccinated," said Dr. Hatfield, "It's very simple, not very expensive. Babies leave the clinic just as they came in."
Expert Reaction
The strategy becomes one in an armamentarium of safer pain relievers for children.
"What's shaking out is a combination of things that can be used safely in pediatricians' offices that are useful to the child," said Kenneth R. Goldschneider, MD, director of the division of pain management at Cincinnati Children's Hospital Medical Center in Ohio. "Sucrose, swaddling, kangaroo care (direct, skin-to-skin contact with a parent), non-nutritive sucking [a pacifier with nothing on it], topical analgesics, use of thinner needles and proper injection site selection (are all) means to keep painful interventions from being overly stressful. None of them are perfect, but they are safe, and work at least reasonably well."
