Based on these four studies, two of which were subgroups of small numbers of eligible toddlers from larger studies, there is insufficient evidence of the analgesic effects of sweet tasting solutions or substances during acute painful procedures in children over one year of age. Further well-conducted RCTs are warranted in this population.
Sucrose as an analgesic agent for infants during immunization injections.
To assess the effectiveness of sucrose as an analgesic agent during routine immunization injections for infants (age range, 2 weeks to 18 months).
                Double-blind, randomized control trial.
                Ambulatory care clinic of a large tertiary care center.
                A consecutive sample of 285 infants were randomly assigned to one of three treatment groups.
                Subjects received either no intervention or drank 2 mL of sterile water or 2 mL or a 12% sucrose solution 2 minutes before administration of the immunization.
                Infants were videotaped during immunization for later interval recording of pain-induced vocalizations.
                Results were analyzed by using two-way repeated measure analyses of variance. Two-week-old infants who received either the sterile water or sucrose solution cried significantly less than infants who received no intervention (F=5.92,P<.005). For older infants, those who received water or sucrose cried significantly less only if they were administered one injection rather than two injections (F=3.36,P<.05).
                We found that when infants drank sucrose or sterile water, significantly fewer pain vocalizations were produced, but only for 2-week-old infants. For older infants, differences were found only when the number of injections was included in the analysis. We expand on previous findings by demonstrating that both the age of the child and the number of painful exposures can attenuate calming effects. In addition, the results suggest that in the absence of nonnutritive sucking, the actual analgesic effects of sucrose may be nonspecific. Further study is needed of the possible analgesic effects of sucrose.