Doctors should stop giving newborn babies sugar to relieve the pain of minor medical procedures because it does not work and may damage their brains, new research in The Lancet warns today.
The study says that small doses of oral sucrose do not reduce the pain which a baby feels when its heel is pricked to yield a blood sample or it has a drip put in to receive antibiotics.
Its conclusions directly challenge existing medical practice. Infants are routinely given tiny amounts of sugar in hospitals, both in the UK and around the world, as a way of limiting the pain they feel when they undergo short but painful procedures. Sick babies who receive sustained treatment in the early weeks of their lives may receive many doses to help them cope with repeated invasive procedures, which also include having an injection or having blood taken from a vein.
"Our findings indicate that sucrose is not an effective pain relief drug. This is especially important in view of the increasing evidence that pain may cause short and long-term adverse effects on infant neurodevelopment," said Dr Rebecca Slater, who led the Medical Research Council-funded study at University College London. "While we remain unsure of the impact sucrose has, we suggest that it is not used routinely to relieve pain in infants without further investigation."
Babies are usually given a dose of one-tenth of a gram of sucrose, a concentrated sugar solution, into their mouths before a procedure starts because doctors believe that it reduces, but does not remove, the pain involved. Many previous studies have found that the practice works, including a review of all the existing medical literature on it published earlier this year by the authoritative Cochrane Review.
But those studies were flawed because they relied on the change in the baby's facial expression upon receiving the sugar, from puckered-up to relaxed, as proof that it works, the new study says.
Instead, using different ways of measuring babies' reactions to the procedures, it has found that infants continue to feel pain, despite receiving the substance, as shown by measurements of the levels of pain activity in their brains and spinal cords after 59 newborns had undergone a routine heel prick test. Examination of the babies' leg reflexes also indicated that they felt discomfort despite receiving the sugar.
Neena Modhi, a professor of neonatal medicine at Imperial College London and a vice-president of the Royal College of Paediatrics and Child Health, said: "This is an important study. Sucrose is given because it seems to work. If it's confirmed that sucrose doesn't work, we have a problem because we don't have any effective treatments for acutely painful procedures in newborns."
But Modhi added that a bigger study, involving more babies, was needed and drug companies should speed up the development of treatments .