No parent wants to hear a new baby scream with pain, but we know it is going to happen at each of those early well-child checkups. Immunizations always make parents feel a little guilty because we have to help hold our baby still while the nurse injects their little legs. When the child being immunized is newly placed with you for adoption, it is even harder to be the injection helper. You are trying to bond with your baby and you really don’t want to be associated with painful experiences. I learned a little trick 24 years ago when my oldest son was born to help with immunization pain. While waiting for the nurse to enter with the immunizations I give the baby the recommended dosage of Tylenol. Giving the pain reliever before the injection always seems to reduce crying time and eliminate the pain and fever that can occur after shots. After 24 years of using this technique, I was surprised to learn that a little sugar water could have the same outcome.

Linda Hatfield, an assistant professor of public health services at the Pennsylvania State University School of Nursing in University Park, along with her colleagues performed the following study. They randomized 100 infants who were two and four-month-old to receive either oral sucrose or a placebo (sterile water) two minutes before routine immunizations. They assigned a pain score by taking into account each baby’s crying, facial expressions, body movements, behavioral indications, and sleep. The infants who received sucrose showed lower pain scores at five, seven, and nine minutes after being given the solution. By the time nine minutes had passed these infants had an average pain score that was 78.5 percent lower than the placebo group.

Dr. Kenneth R. Goldschneider, director of the division of pain management at Cincinnati Children's Hospital Medical Center in Ohio made the following observations.

"Sucrose, swaddling, kangaroo care [direct, skin-to-skin contact with a parent], non-nutritive sucking [a pacifier with nothing on it], topical analgesics, use of thinner needles and proper injection site selection [are all] means to keep painful interventions from being overly stressful. None of them are perfect, but they are safe, and work at least reasonably well."

In the first two years of life, infants and toddlers receive as many as 24 injections. An infant may receive as many as five injections at a single well-child visit. Some parents are reluctant to bring their infants in to be immunized because of the pain and stress. There's also some indication that exposure to pain early in life might have long-term neurological effects.

American and Canadian pediatric groups already recommend the use of sucrose for minor painful procedures in neonates. Research has indicated that exposure to sucrose causes a release of the body's natural pain-relieving chemicals.

For a complete list of immunizations and the recommended ages for receiving them visit the CDC website.

Photo Credit Julia Fuller 2006
Our beautiful newborn Ami