title: A sugar-coated pacifier reduces procedural pain in newborns.
abstract: OBJECTIVE
  To examine the efficacy of pacifiers and sugar, alone and in combination, for pain management in neonates.
  
  
  METHODS
  An experimental design examined pain responses of 84 newborns undergoing heelstick. They were randomly assigned to one of four groups: (a) water-moistened pacifier, (b) sugar-coated pacifier, (c) 2 cc of a 12% oral sucrose solution, or (d) control. Pain measures were duration of cry, vagal tone, and salivary cortisol.
  
  
  RESULTS
  Multivariate analysis of variance (MANOVA) revealed that the sugar-coated pacifier group cried significantly less than the water-moistened pacifier and control groups. Repeated measures analysis of variance (ANOVA) revealed that the sugar-coated pacifier group demonstrated significantly lower vagal tone during heelstick than the oral sucrose solution and control groups. This difference between the sugar-coated pacifier and control groups persevered for 15 minutes after heelstick.
  
  
  CONCLUSIONS
  Offering a sugar coated pacifier during heelstick in healthy neonates reduces pain behaviors more effectively than a water-moistened pacifier, 2 cc of a 12% sucrose solution, or no intervention.
authors.affiliation: California State University, Fullerton Department of Nursing, Lake Forest, CA, USA.
authors.forename: Cindy Smith
authors.initials: CS
authors.lastname: Greenberg
mesh_terms: D000284:Administration, Oral; D001800:Blood Specimen Collection / Q000009:adverse effects*; D003448:Crying; D005260:Female; D006365:Heel / Q000098:blood supply*; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis; D007224:Infant Care / Q000592:standards*; D007231:Infant, Newborn; D008297:Male; D015999:Multivariate Analysis; D015403:Nursing Evaluation Research; D010146:Pain / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control*; D010147:Pain Measurement / Q000379:methods; D012463:Saliva / Q000737:chemistry; D013395:Sucrose / Q000008:administration & dosage*; D014630:Vagus Nerve / Q000503:physiopathology
chemical_list: D013395:Sucrose; D006854:Hydrocortisone