Artificial sweetener reduces nociceptive reaction in term newborn infants

Background: Sucrose has been shown to have an analgesic effect in preterm a nd term neonates. Sucrose, however, has a high osmolarity and may have dele terious effects in infants with fructose intolerance. Furthermore, it may f avour caries. We therefore investigated the effects of a commercially avail able artificial sweetener (10 parts cyclamate and 1 part saccharin), glycin e (sweet amino acid) or breast milk in reducing reaction to pain as compare d with a placebo. Subjects: Eighty healthy term infants, four days old, wit h normal birth weight. Interventions: The infants were randomly assigned to one of four groups: 2 mi sweetener, glycine, expressed breast milk or wate r were given 2 min before a heel prick for the Guthrie test. The procedure was filmed with a video camera and analysed by two observers who did not kn ow which medication the infant had received. Results: Using a multivariate regression analysis, the following variables had significant correlation wi th relative crying time and recovery time: behavioural state before the int ervention, the pricking nurse, and die type of medication. Relative crying time and recovery time were significantly less in the sweetener group but n ot in the glycine and the breast milk group. Conclusions: The artificial sw eetener used in our study reduces pain reaction to a heel prick in term neo nates, and thus provides an alternative to sucrose. In contrast, glycine te nds to increase pain reaction whereas breast milk has no effect. (C) 2000 E lsevier Science Ireland Ltd. All rights reserved.