Oral Sucrose Toolkit

Last modified by Lisa Stromquist on 2017/09/15 15:52

Welcome to the toolkit about how procedural pain and distress can be minimized for infants. Current best evidence supports the use of these techniques for children aged 0 to 1 years, including premature babies.


Children undergo painful needle-related procedures such as blood collection and immunisation. Provision of appropriate and effective analgesia for these procedures is important. Untreated pain as a result of medical procedures not only results in immediate pain, distress, and anxiety at the time of the procedure, but has the potential to lead to longer term sequelae, including increased pain at subsequent procedures and fears of needle pain.” (Harrison et al., CDSR, 2014). 

Physical and psychological interventions can also be used in conjunction with pharmacological (ie oral sucrose) pain management. Links to recommendations and resources for these techniques can be found through the main webpage for the CAPHC acute procedural pain toolboxes. 

The purpose of this toolkit is to make the adoption of using oral sucrose for infants while when performing painful procedures easier in your clinical practice. We have seen oral sucrose successfully used for venipuncture, intravenous cannulation, lumbar puncture, urinary catheterization, and other such common medical procedures. We strongly urge you to consider utilizing more than one complementary intervention, along with the sucrose, for such procedures (ie topical anesthetic for lumbar puncture in addition to sucrose). The contents, which have been provided by your clinical colleagues around the country, can help you move these interventions into your regular practice, help create a policy for use their use in your organization, support clinical education in pain minimizing techniques for suturing, and provide clinical resources to make these techniques easier to use. Use as many of the resources as you need and modify them to fit your organizational context. 

Examples of policies are provided for reference purposes, only. We encourage all users of the toolbox who wish to adopt a similar policy at their institution to review, adapt, and modify the examples, as needed. The providers of these examples do not endorse their use outside of the institution for which it was originally created.


In this kit you’ll find:

  • Family resource, including a brochure to explain to families how sucrose works, and why you might want to use it.
  • An example of multiple hospital policies  for the use of oral sucrose for the treatment of brief procedure-related pain. This policy can be used to create your own organizational policy based on your needs and context.
  • Clinical PowerPoint presentation developed by your clinical colleagues to support education about using sucrose for infants. These slides can be modified and delivered for your needs and context  but please acknowledge the original authors and the CAPHC Pain CoP for their contributions.
  • A video demonstrating how to use oral sucrose, which can be shared with families or health care providers.
  • Background articles outlining the current best research evidence to support using oral sucrose (including articles regarding sucrose efficacy in other age groups).

If you have any comments, questions or additions for the box, please contact CAPHC at info@caphc.org

Thank you for supporting the CAPHC Pain Community of Practice’s mission to improve health outcomes for infants and children by reducing pain experienced during medical procedures, healthcare interventions and chronic conditions, disease or disability. 

Family Resources CHEO - What you Need to Know (family pamphlet)
Clinician Resources TREKK Bottom Line Recommendations: Procedural Pain (Translating Emergency Knowledge for Kids trekk.ca)
Hospital PolicyAlberta Health Services  Sucrose Policy
BC Children's Sucrose Policy
Orillia Soldier Memorial Hospital Sucrose Clinical Protocol
Toronto East General Hospital Sucrose Policy - Neonatal
IWK NICU Admitting OrdersIWK NICU Short Stay Admitting Orders
Clinical PowerPoint Sucrose for Managing Procedural Pain in Infants - PowerPoint
Sucrose for Managing Procedural Pain in Infants - PDF
 VideoDeveloper: Dr. Denise Harrison
From: Children's Hospital of Eastern Ontario (CHEO), CHEO Research Institute, University of Ottawa
Title and video link: Be Sweet to Babies: Reduce your infant’s pain during newborn blood tests
Background Articles List of Background Articles PDF

Sucrose for analgesia in newborn infants undergoing painful procedures.Stevens B, Yamada J, Lee GY, Ohlsson A.Cochrane Database Syst Rev. 2013 Jan 31;1:CD001069. doi: 10.1002/14651858.CD001069.pub4. Review.PMID: 23440783

A systematic review and meta-analyses of nonsucrose sweet solutions for pain relief in neonates.Bueno M, Yamada J, Harrison D, Khan S, Ohlsson A, Adams-Webber T, Beyene J, Stevens B.Pain Res Manag. 2013 May-Jun;18(3):153-61. Review.PMID: 23748256

Sweet-tasting solutions for needle-related procedural pain in infants one month to one year of age.Kassab M, Foster JP, Foureur M, Fowler C.Cochrane Database Syst Rev. 2012 Dec 12;12:CD008411. doi: 10.1002/14651858.CD008411.pub2. Review.PMID: 23235662

Sweet tasting solutions for reduction of needle-related procedural pain in children aged one to 16 years.Harrison D, Yamada J, Adams-Webber T, Ohlsson A, Beyene J, Stevens B. Cochrane Database Syst Rev. 2015 May 5;5:CD008408. doi: 10.1002/14651858.CD008408.pub3. Review.PMID: 25942496
Created by Lisa Stromquist on 2015/12/23 21:03