**Sweet Solution Analgesia**

Khawla Nuseir, Manal Kassab and Mohammed Al-Azzani

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/66596

#### **Abstract**

Mammals' first tasting experience is usually sweet solution. Whether it is milk (breast or formula), sugar water as in some cultures or even dates as advocated by Prophet Mohammed to his followers. Thus, it is no wonder the soothing, calming and even pain relieving effects of oral sweet solutions. Nevertheless, using sweet solution purposely for its pain-relieving effects for infants in the clinical setting is relatively recent; however, the discussion concerning sweet solution effectiveness, mechanism of actions and adverse long-term effects are still ongoing. In this chapter, we present an account of studies on both humans and animals that explored and examined the use of several sweet solutions for analgesia.

**Keywords:** premature, infants, pain, NICU, sucrose

## **1. Introduction**

Young children are subjected to undergo many painful medical procedures early in their life. Althoughthese procedures are performed even in healthy children, they are more common in sick ones who need an admission to the hospital. Treating pain in the newborn is essential; firstly, for ethical reasons and, secondly, because pain can lead to several physiological and psychological effects. Not only such negative consequences are not related to repeated painful procedures but even short-term pain can have lasting negative effects [1]. Young children, including neonates, are more sensitive to nociceptive stimuli than adults [2]. Research findings emphasized that repeated exposure to painful stimuli during early stage of fundamental development of the nervous system leads to persistent behavioral and sensory changes [3]. Despite this fact, the use of appropriate pain relief interventions during potentially painful procedures is unusual in this population [4]. A paradox is still observed between the frequency of conditions that cause pain among young children and the use of

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appropriate pain relief intervention. The most often cited causes for this paradox are the several myths surrounding the painful experience in the neonatal population, particularly the perception that the newborn is too immature to feel pain [5]. It is known that the knowledge about the presence of pain in newborns has greatly increased among health providers who are responsible for neonatal care [6], but it is not known how each professional puts such knowledge into practice [7]. Young children including neonates do not have the ability to verbalize their pain thus health care providers must recognize their pain. Not only unmanaged pain causes distress and delayed recovery but pain in infancy also has short-term (physiological and behavioral) and long-term developmental consequences (increased or decreased behavioral responses to pain). Although infant's pain is not expressed as conscious memory, memories of pain may be recorded biologically and alter brain development and subsequent behavior. Some recent studies have reported that simple and benign interventions such as oral sweet solutions [5, 8, 9], milk [10] or sucking a pacifier [11] reduce pain in neonates during procedures. Pain relieving effects of sweet solutions such as sucrose have been examined in term and preterm neonates [12, 13]. Glucose and other sweet tasting solutions have also been found to have pain relieving effects [9]. The effect of sugar on calming a crying baby during painful procedure is not new but there are historical references pertaining to the analgesic and calming benefits of sweet substances dating back to AD 632, when Prophet Mohammed recommended giving infants a well-chewed date [14]. Also Thorek, in his textbook, *Modern Surgical Technique*, published in 1938, explained his ideas of acceptable pediatric anesthesia: "Often no anesthesia is required. A sucker consisting of a sponge dipped in some sugar water will often suffice to calm a baby" [15].
