UMEM Educational Pearls

Category: Pediatrics

Title: Sweets Before Sticks

Posted: 4/11/2014 by Rose Chasm, MD (Updated: 4/6/2020)
Click here to contact Rose Chasm, MD

  • Male infants are routinely given a sweet solution prior to circumcision for analgesia.
  • Michelis and Hoyle recently published a great review of the possible use of sweet solutions in the ED for pediatric patients.
  • Pediatric patients often undergo painful, but rather routine procedures in the ED such as IV and urinary catheter placement, venipuncture, and lumbar punctures.
  • More often than not, however, they are not provided analgesia prior to these procedures.
  • It is believed that repetitive early pain events lead to anxiety and other behavioral disorders while also decreasing pain tolerance.
  • In children less than 12 months, consider giving a sweet solution (2mL of 24% sucrose) 2 minutes before any painful procedure.
  • Multiple studies indicate decreased pain as measured by significantly reduced crying times.
  • It's cheap, safe, and works!


  1. Michelis EA, Hoyle JD. Sweet Solutions and Needle-Related Pain in Infants. Ann of Emerg Med. 2014, Vol 63, Issue3.
  2. Available at:
  3. Kassab M, Foster J, Fowler C. Sweet-tasting solutions for needle related procedureal pain in infants one month to one year. Cochrane Database of Systematic Reviews 2012, Issue 12. Art. No.: CD008411.
  4. Stevens B, Yamada J, Ohlsson A. Sucrose for analgesia in newborn infants undergoing painful procedures. Cochrane Database Syst Rev. 2013;(1):