Denise, I share your concern about the gut integrity of babies given
sucrose, especially repeated doses in premature babies.

I know of at least one person, the Danish midwife Charlotte Overgaard, who
has examined the effect of sucrose separately from cuddling or suckling, and
found that it has an effect.  She found that babies who were agitated at the
outset, settled better and showed less signs of pain when given sucrose
before a heel stick, than if they were given nothing.  Babies who were calm
already, as after a good breastfeed, did not react as strongly as agitated
babies, but even these babies showed less signs of pain if given sucrose.
These were babies coming for PKU tests, NOT premature or ill babies
repeatedly subjected to painful procedures.  They were held and cuddled by a
parent during the procedure, and some were given plain water, others sucrose
solution.  At this site, you can read the abstract of her work, it is NLM
CIT. ID: 99196722
http://heelspurs.com/alltitles.html
Using expressed breastmilk in the same quantities doesn't seem to do the
trick, and why should it?  Hardly anyone drinks breastmilk 0.1 ml at a time,
that is barely enough to wet the tip of the tongue.  But breastfeeding helps
in term babies, at least.

My own observation is that hungry babies really don't like being stuck, but
sated babies hardly react at all.  Breastfeeding babies act like sated
babies.  You see a burst of a few 'urgent' sucks immediately following the
stick, and then they just go back to business.  Their bodies stay relaxed,
whereas when they are on a mattress they draw their foot up, or try to
escape, unless they are so sated that they just go back to sleep.  I try to
avoid sticking hungry babies whenever possible, and I have sucrose solution
available if the parents request it, or if I feel the baby is so unsettled
even after feeding that it would be a help to give it, in which case I
request permission from the parents.  Sometimes fathers bring babies in
alone, and it is a *bit* harder for them to breastfeed, IME.

A nurse in our NICU did a study to see whether giving oral sucrose as
analgesia affected blood glucose levels, and found that it did not.  Before
that, babies having glucose checks were not given this analgesia for fear it
would give a falsely high reading.

I welcome the acknowledgement of infant pain, and appreciate what NICU
staffs are doing to care for their patients in sensitive ways.  I wish we
would stop building new NICUs that don't have beds for mothers (or fathers)
beside every isolette or cot.  It would make life better for the babies and
the parents, and ultimately the staff, if they did not have to be separated
at all.

Rachel Myr
Kristiansand, Norway

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