The manufacturer of Sweet-Ease recommends its use as follows:

Sweet-Ease is a 24% sucrose and water solution. Sucrose is an all natural, non-pharmacologic intervention that has been widely studied and proven to be associated with statistically and clinically significant reductions in discomfort to the infant.
Sweet-Ease is effective for calming and soothing babies up to six months of age. It is packaged in a 51mm translucent, spill-resistant cup (filled to 15ml). It may be used in all areas of the hospital, including the NICU, PICU, newborn nursery, ER and pediatrician’s office and combines with our Wee Thumbie and other pacifiers to help calm and soothe distressed babies.

TootSweet has the same indications: According to clinical studies, 24% sucrose solution is considered safe and effective for reducing procedural pain from single painful events (such as heel lance, line placement and circumcision) and to help calm and soothe babies in distress or during painful procedures. In reading about TootSweet at the manufacturers website, they classify TootSweet as a food, with sucrose’s clinical efficacy being a result of mucosal absorption, not ingestion. However, its indication for use is to provide pain relief from minor painful procedures. Used for pain relief it would still meet the requirements for an exclusively breastmilk fed infant.

Using these preparations to entice an infant to the breast would technically be an off-label use. Many hospitals yell and scream that staff cannot use modified syringes to help evert flat nipples, so in my mind using Sweet-Ease or TootSweet for this purpose may not be an approved use in many hospitals. I have seen these products used to entice infants to the breast, usually with negative results. There is no data to support their use in this manner, so it is really not an evidence-based intervention. I believe there are better ways to entice reluctant infants to the breast and follow somewhat of a mental hierarchy or algorithm when I work with such infants or teach clinicians these techniques.

Marsha Walker, RN, IBCLC
Weston, MA







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