Taking the ‘ouch’ out of needles for babies: as easy as 1-2-3


Corrine Langill, RN, BScN   CHEO

Manager, Health Promotion and Injury Prevention 

Children's Hospital of Eastern Ontario

We've all been there, trying to comfort our baby as she protests LOUDLY after a needle.  Or trying to keep a howling baby still so the nurse can take a blood sample or give the vaccine.  The baby is upset, parents are upset, and other babies and young children in the waiting room are becoming unsettled too.  Health Care Providers also find it challenging, as they try to give injections or draw blood quickly, efficiently, and under pressure.

Enter Dr. Denise Harrison.  She's come up with 3 simple steps to make needles as painless as possible for everyone.  Through her research, she's found that breastfeeding, skin-to-skin cuddling or a small amount of sugar water (sucrose or glucose) can reduce the pain of needles by quite a lot. 

1.  Breastfeeding

If you are breastfeeding, this is the first thing to try.  It brings many comforts: skin to skin contact, mum's warmth and scent, and the pleasure of sucking and feeding.  It's also possible that the endorphins (natural painkillers made in our brains) in breast milk help to reduce pain.  When babies up to a year old are settled on the breast, they may barely raise an eyebrow when they receive an injection or have a blood test.   Research shows that this is most effective for babies up to a year, but toddlers may still find comfort nursing during a needle.  Some people have worried that breastfeeding during needles might cause babies to think their mum caused the pain, or cause babies to choke on the milk.  Dr. Harrison's research studies have found that neither of these is true.

2.  Skin-to-skin cuddling

For babies who aren't breastfeeding, close skin to skin contact can work well.  This also gives dads a chance to be involved.  Remove the baby's clothing, except for a diaper, and place the baby on your bare chest.  The baby needs to be settled and resting on mum's or dad's chest for about 10-15 minutes before the needle.  This is most helpful in the early newborn period.  It's used often with preterm babies in NICUs (Neonatal Intensive Care Units).

3.  Sucrose solutions

Sucrose solutions also work well for babies up to a year old, if breastfeeding or skin to skin contact isn't possible.  At the moment, sucrose solutions aren't available in Canadian stores.  Hopefully, they'll be available by March, 2017.   You can also make your own sucrose solution at home. Researchers aren't exactly sure how sweet tasting solutions work.  But it's most likely that sucrose sends a message to the baby's brain to produce endorphins (our body's natural painkillers).  Give very small amounts of the sucrose to your baby with an oral syringe, about a minute before the injection.  If your baby uses a pacifier, sucking may also help to reduce needle pain.  The pain reducing effect lasts from 1-2 minutes - perfect for a vaccination or blood test.

Planning for vaccines and blood tests

If your baby has a blood test or vaccine coming up, let your health care provider know ahead of time that you plan to breastfeed, use skin-to-skin or sucrose.   Give yourself time to get your baby relaxed and settled on the breast or chest.  If you're giving sucrose, give it about a minute before the injection, so it has time to take effect. 

Public Health Nurses are very familiar with these practices.  Other health care providers may not have heard about these yet.  If your provider has questions, let her know that breastfeeding during vaccination is recommended by the WHO (World Health Organization).  Some providers may find it more comfortable to sit to give injections while you're breastfeeding or cuddling skin-to-skin.  Both parents and health care providers will appreciate the chance to talk without having to cope with a crying baby.

Breastfeeding, skin to skin contact or sucrose solutions can really take the sting out of needles and blood tests.  Start early, with the newborn screening blood tests your baby will have shortly after birth.  Reducing pain during blood tests and needles early on can reduce fear of needles as a child grows.  This means less pain and upset for everyone:  babies, parents, health care providers and everyone else in the waiting room. 

Did you know?

  • CHEO and Ottawa Public Health staff supports breastfeeding, skin to skin contact and sucrose solutions to reduce the pain of injections, blood tests and other medical procedures.
  • You can make your own sucrose solution.  Mix about 5 mL (one teaspoon) sugar with about 10 mL (two teaspoons) water.  Make sure you discard any remaining solution after the needles. You don't need this at home. 
  • Sucrose solutions for pain contain less sugar than many commonly used syrups (like vitamins or pain and fever medications).  And when used as directed - in small amounts before and during needles, they don't cause cavities.
  • Honey, corn syrup or molasses can contain botulism spores that can lead to botulism poisoning.  This is rare, but very serious.  Do not use these products to manage pain. 

Watch how breastfeeding, sweet solutions and skin contact work-check out these videos!

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