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Sugar Water Eases Pain of Infant Vaccinations
Date:2/4/2008

Study found it lowered pain scores by more than 78%

MONDAY, Feb. 4 (HealthDay News) -- While a spoonful of sugar helps the medicine go down, a new study shows it may also ease the pain of vaccinations.

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 study author Linda Hatfield, an assistant professor of public health services at the Pennsylvania State University School of Nursing in University Park. "It's very simple, not very expensive, babies leave the clinic just as they came in."

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 Dr. Kenneth R. Goldschneider, 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."

According to Hatfield, 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. Her study is in the February issue of Pediatrics.

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 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," 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.

American and Canadian pediatric groups already recommend the use of sucrose for minor painful procedures in neonates.

Hatfield and her colleagues randomized 100 2- and 4-month-old infants to receive either oral sucrose or a placebo (sterile water) 2 minutes before routine immunizations.

Pain was assessed with a score which took into account crying, facial expression, body movement, behavioral indications and sleep.

The sucrose group showed lower pain scores at 5, 7 and 9 minutes after being given the solution and, by 9 minutes, had a mean pain score 78.5 percent lower than that of the placebo group.

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.

Is it a good idea to give sugar to young babies? 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.

As for how sugar works, Goldschneider pointed to previous research proposing a link between exposure to sucrose and release of the body's natural pain-relieving chemicals.

More information

See the childhood immunization schedule at the U.S. Centers for Disease Control and Prevention.



SOURCES: Linda A. Hatfield, Ph.D., CNNP, assistant professor, public health services, Pennsylvania State University School of Nursing, University Park; Kenneth R. Goldschneider, M.D., director, division of pain management, Cincinnati Children's Hospital Medical Center, Ohio; February 2008, Pediatrics


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