New Research Finds Sucrose Does Not Prevent Long-Term Developmental Effects in Preterm Infants Despite Pain Relief Use

Preterm infants often spend extended periods in neonatal intensive care units (NICUs), where they face numerous medical procedures aimed at supporting their fragile health. These procedures, frequently exceeding 16 daily, include blood tests like heel pricks and airway suctioning, many of which are acutely painful. While such invasive interventions are essential, their pain can influence brain development, stress regulation, and later cognitive and behavioral outcomes.

A common approach to manage these acute pains has been administering sucrose, a sugar solution known to activate pain-modulating centers in the brain and trigger the release of endorphins. Despite its widespread use as a standard of care, recent research indicates that sucrose does not mitigate the long-term impacts associated with early-life pain exposure.

This investigation, conducted across three NICUs in Canada, compared children who received sucrose with those who did not, focusing on outcomes at 18 months old. The results confirm previous findings: preterm children exposed to substantial painful procedures demonstrated increased anxiety, depression, and difficulties in cognition and language, regardless of sucrose administration. This suggests that while sucrose may provide short-term pain relief and reduce visible discomfort, it does not prevent underlying neural or physiological changes linked to early pain experiences.

Given these insights, healthcare providers are encouraged to re-evaluate current pain management protocols. Minimizing unnecessary procedures, utilizing less invasive ventilation options, and integrating mother-infant bonding strategies like skin-to-skin contact have shown promise in reducing pain and its long-term effects. Additionally, promoting parental involvement and exploring alternative pain relief methods such as expressed breast milk could improve health outcomes.

In New Zealand, where preterm birth rates are notable, especially among Māori and minority groups, the lack of standardized guidelines for pain management highlights the need for updated research-informed policies. International evidence suggests that routine pain assessments and reducing procedural frequency can help decrease adverse long-term developmental issues. Continued exploration of effective, culturally appropriate pain management strategies is crucial for improving the lifetime well-being of these vulnerable infants.