Hi! from cloudy South Florida in the 80's. Loriann you wrote about Sweetease, the 24% sucrose used for pain management in babies.
It got it's reputation with use during circumcisions when local anesthesia wasn't popular. 
It also is prescribed as in my hospital during any procedure that may produce pain or discomfort like heelsticks, blood draws, catheter insertions for Voiding Urethral Cystograms as well as when the babies are first placed on circ board and during the ring block of anesthesia.
So in many institutions it is standard.  Emla is passe. It also was not as effective.
I have tried not to load these babies up with all the sucrose and either use a gloved finger or pacifier but despite all the help some babies are really fussy and we do have to chart the pain toleration before, during, and after the circ or procedure as well as when the circ check is done.  I usually try to get babies on to breast asap procedure.
I have a few lab technicians who will encourage Moms to breastfeed while they do blood draws if they are heel sticks.  I have found docs who are really neonatalogy based are more into the Sweetease and  regular pedis are not so much.
OBs are mandated to use local anesthesia for circs and will be written up if they refuse. 
I advise Moms that some babies will not breastfeed as well after circs on first day, Recommend they do skin to skin let baby nurse as long as the baby chooses to and after circ check and teaching to get baby back on breast for comfort. Am amazed how much Moms don't want to use themselves to comfort and soothe their child after they have chosen to have the baby undergo such pain.  Am always happy to see them wait on the circ for after discharge either for a bris or do as outpatient or defer it especially if the baby is Late Preterm or not breastfeeding well to begin with. ( Always interested in how they defer the Hepatitis B vaccine so as not to traumatize the baby but are asking how soon the baby will be circumcised or if the girls will have their ears pierced. No, we don't pierce ears in the hospital.)
So that is how we manage pain in South Florida.
Leanne Jewell RN-BC, IBCLC, LCCE,FACCE
 

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