New perspective for pain control in neonates: a comparative effectiveness research

J Perinatol. 2021 Sep;41(9):2298-2303. doi: 10.1038/s41372-021-01025-6. Epub 2021 Mar 4.


Objective: To compare sucrose 24% oral gel formulation to liquid formula and breastfeeding during a heel prick in neonates.

Study design: In this comparative effectiveness research 195 neonates >36 weeks' gestation were randomised to three groups, receiving during heel stick: (i) breastfeeding, (ii) sucrose 24% liquid with non-nutritive sucking and (iii) sucrose 24% gel with non-nutritive sucking. The pain was assessed through the Neonatal Infant Pain Scale.

Results: All the methods analysed has shown to be effective in reducing pain. There was an increase in odds of pain following liquid sucrose compared to breastfeeding (OR = 1.60; 95% CI: 0.82-3.3; p = 0.17). A reduction of odds of pain was showed comparing sucrose to breastfeeding (OR = 0.78; 0.38-1.6; 0.48), and comparing sucrose gel to liquid formula (OR = 0.48; 0.23-0.96; p = 0.04).

Conclusion: Sucrose 24% gel with non-nutritive sucking seems to be a valid alternative when breastfeeding is not possible. Further research is needed.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Comparative Effectiveness Research*
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Premature*
  • Pain / etiology
  • Pain / prevention & control
  • Pain Management
  • Pain Measurement
  • Sucrose


  • Sucrose