Oral Sucrose for Pain Relief

What is oral sucrose?

Oral sucrose is a simple sugar solution (sugar water) given as a liquid by mouth. It can comfort infants and toddlers during brief medical procedures that could cause pain. Your child’s care team will place the oral sucrose either inside their cheek or on their tongue. Sucking on a pacifier may increase the effect of oral sucrose. But it will still work if your baby cannot use a pacifier.

Oral sucrose is a comfort measure. It can be used with other comfort measures, such as holding your child, swaddling them, changing positions, and distracting them. 

Benefits of oral sucrose 

Benefits of oral sucrose include:

• Reduces crying after a painful procedure
• Stimulates natural pain-relieving chemicals 
• Calms and soothes
• Is safe to use
• Is non-invasive
• Reduces the need for other pain medicines
• Is easy to give by oral syringe or dropper in the mouth

How oral sucrose is given

The care team will give drops of oral sucrose on your child’s tongue 1–2 minutes before an event or procedure. For younger infants, the dose is usually 1–2 drops. For older infants, more oral sucrose may be given. Your child may also use a pacifier to suck on. 

The dose of oral sucrose may be repeated every 2 minutes (up to 4 times) during the event or after if needed. The peak pain-relieving effects of oral sucrose last around 2 minutes. 

When oral sucrose is used

Oral sucrose is used in children up to 2 years old during short, painful, or uncomfortable procedures such as:

• Needle sticks, including heel pricks, taking blood samples, or giving injections (shots)
• Starting an IV (intravenous) line
• Removing an epidural
• Dressing (bandage) changes or removing tape from the skin
• Wound care
• Lumbar punctures
• Bone marrow aspiration or biopsy
• Suctioning the nose or trach
• Placing or removing a urinary catheter
• Chest tube insertion or removal
• Inserting a nasogastric tube
• Eye exams

Side effects of oral sucrose 

If used properly, oral sucrose has very few side effects. Talk to your care team to see if oral sucrose is right for your child.

Who should avoid oral sucrose

Oral sucrose is not right for your child if they have:

• Problems digesting food or liquids
• Scheduled lab tests or procedures (including sedation, general anesthesia, and PET scans) that require fasting or NPO instructions (directions to go without food and liquids before a procedure)
• A breathing tube or paralysis
• Necrotizing enterocolitis (NEC), a disease that destroys part of the intestine
• Recent oral surgery
• Grade 3 or 4 mucositis, which causes ulcers and pain in the mouth and digestive tract
• Diabetes (high blood sugar) or unstable blood sugar
• Inotropic drug therapy for heart problems
• Decreased gag reflex

Other comfort measures

Along with oral sucrose, you may want to try comfort positions or offer other comfort measures to your child.

For younger infants, you may:

• Hold them in a comfortable position
• Swaddle them
• Dim the lights
• Use skin-to-skin contact
• Breast or bottle feed before the procedure

For older infants or toddlers, you may:

• Hold them in a comfortable position
• Make eye contact
• Talk softly
• Avoid extra talking in the room
• Play soft music or sing quietly
• Use a favorite blanket or stuffed animal

Before the procedure, you or the care team may want to explain to your child what will happen and let them explore or hold some of the medical equipment.  

Questions to ask your care team

• Can oral sucrose help my child with pain?
• Is oral sucrose safe for my child?
• How, when, and how much is given?
• What should I do if my child has any kind of reaction to oral sucrose?
• How do I ask for oral sucrose if the care team does not offer it?
• What other measures can I take to comfort my child during painful procedures?
• When should I call the care team?