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Infants’ Injection Pain Relieved With Sugar Solutions!

by Dr. Shalini Aul on Aug 1 2011 12:28 PM
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“Healthcare professionals should consider using sucrose or glucose before and during immunization.” Dr. Denise

The trauma and pain associated with vaccinations or minor painful procedures in infants from one month to twelve months can now be relieved simply by feeding them with sugar solutions! This finding has been reported by Denise Harrison, RN, PhD, of the Department of Pediatrics of the “Hospital for Sick Children” in Toronto, Canada and her colleagues as published in the “Archives of Disease in Childhood”.

The application of pain relieving effects of sucrose and glucose in newborns has been in vogue for a while but little was known about the analgesic effects in children beyond the newborn period. This study focused on the effectiveness of sugar solutions in infancy from newborns till about 12 months of age with single or multiple vaccinations.

According to the report, randomized controlled 695studies from the internet and other resources were researched and the results were pooled together evidently to establish this finding. An analytical review of 14 randomized controlled trials which included 1,674 total injections given was done. Oral glucose or sucrose solutions in varying consistencies were matched with water or no treatment. There was a moderate decrease in the incidence and duration of crying in 13 of the 14 randomized controlled trails.

According to Dr. Denise “Healthcare professionals should consider using sucrose or glucose before and during immunization.” She also recommends other strategies to reduce physical or psychological pain along with sucrose or glucose solutions such as non-nutritive sucking, distracting the child or breast-feeding.

Accordingly, the analgesic effect appears to progressively reduce as the infant’s age increases with the maximum pain relieving effect of sugar solutions in newborns. The concentrations of sugar solutions ranged from 75% to 12%. Better pain relief was observed with more concentrated 50% sucrose solution than with 25% sucrose and lesser concentrations. A 12% concentrated sugar solution was able to achieve variable pain relief or relatively no pain relief.

The heart rate and salivary cortisol levels of infants were assessed in this study.

Salivary cortisol test is used to study physiological stress-related disorders with cortisol levels usually increasing after any physical and emotional stress and illness. Infants who received sugar solutions together with non-nutritive sucking were reported to have over 30% reduction in salivary cortisol levels from that of the baseline, while infants who received water with or without a pacifier together with oral glucose alone had an increase in salivary cortisol levels following injections.

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To conclude there is an evident pain relief in infants from birth till about 12 months from minor medical procedures and vaccinations by taking sugar solutions with the maximum analgesic effect in newborn infants compared to older children. Therefore, the use of glucose or sucrose can definitely be counted on for making the pain related with injections more tolerable in babies.

Source: Efficacy of sweet solutions for analgesia in infants between 1 and 12 months of age: a systematic review; Denise Harrison et al; Archives of Disease in Childhood.

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