Sucrose as an Infant Pain Reliever: Do Baby’s Faces Lie?

Have you ever promised a child who just hurt themselves a Popsicle or lollipop if they would just calm down?  Did it work?  More often than not, you may have found that it did and the child seemed calmer.

A new study entitled, Oral sucrose as an analgesic drug for procedural pain in newborn infants, conducted by Rebeccah Slater Ph.D. at the University College London tested whether or not sucrose (a form of sugar obtained from sugarcane)  actually assuage infants’ pain.  The study’s findings were first published in The Lancet on September 1, 2010 and suggested that although infant facial expressions were affected by the sucrose their body’s pain receptors were for the most part unaffected by the sugar serum.

Sucrose has been routinely used with newborn babies to help in pain reduction just before undergoing a painful procedure such as a heel pinprick.  Infant’s facial expressions, just as in adults, are normally used to gauge their pain level.  Dr.  Slater and her team of researchers wanted to see if sucrose was effective in alleviating actual pain levels or if the infant’s facial expressions were a façade masking their real pain.  She decided to measure pain receptors in the participant’s brain and spinal cord.

59 newborns were tested at the University College Hospital in London where 29 received 0.5ml of sucrose, given orally, and 30 received sterile water two minutes prior to receiving a heel pinprick.  The infants were chosen randomly by computer, and neither their parents, clinicians, nor researchers knew which solutions were used on which newborns.  Pain levels were recorded both by the participant’s facial expressions using a PIPP scoring method, which is an observational pain score and by their brain and spinal reflex activity.

The results of the study were insightful and interesting.   Dr. Slater found that brain activity after the heel prick did not differ significantly between the sucrose and sterile water groups.  However, the PIPP score (observational pain score from facial expressions) for the infants who received the sucrose was perceptibly lower than the infants who received the water.  However, there were no significant differences in brain activity or spinal cord circuits between the two groups.

The study found that overall sucrose could not be determined to be an effective pain reliever in infants.  Therefore, the ability of sucrose to reduce pain in only the facial expression of infants should not be interpreted as pain relief.