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New perspective for pain control in neonates: a comparative effectiveness research



To compare sucrose 24% oral gel formulation to liquid formula and breastfeeding during a heel prick in neonates.

Study design

In this comparative effectiveness research 195 neonates >36 weeks’ gestation were randomised to three groups, receiving during heel stick: (i) breastfeeding, (ii) sucrose 24% liquid with non-nutritive sucking and (iii) sucrose 24% gel with non-nutritive sucking. The pain was assessed through the Neonatal Infant Pain Scale.


All the methods analysed has shown to be effective in reducing pain. There was an increase in odds of pain following liquid sucrose compared to breastfeeding (OR = 1.60; 95% CI: 0.82–3.3; p = 0.17). A reduction of odds of pain was showed comparing sucrose to breastfeeding (OR = 0.78; 0.38–1.6; 0.48), and comparing sucrose gel to liquid formula (OR = 0.48; 0.23–0.96; p = 0.04).


Sucrose 24% gel with non-nutritive sucking seems to be a valid alternative when breastfeeding is not possible. Further research is needed.

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Fig. 1
Fig. 2: Treatment efficacy in the three groups.


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We thank all the members of our Neonatology Division who gave their contribution to this study. We thank Marco Chiera for his scientific help.


This study did not receive grant.

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Authors and Affiliations



IB conceived the study and wrote the initial manuscript. GV, FR, ID and GVZ reviewed and revised the manuscript. CF performed statistical analysis and reviewed the manuscript. VF and GL conceived the study and reviewed the manuscript. All the authors discussed the results, commented on the manuscript and approved it as submitted.

Corresponding author

Correspondence to G. Lista.

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The authors declare no competing interests.

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Bresesti, I., Vanzù, G., Redaelli, F. et al. New perspective for pain control in neonates: a comparative effectiveness research. J Perinatol 41, 2298–2303 (2021).

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