Baby’s First Drug

Although the gateway theory has been debunked, I’ve always wondered if the first drug we encounter in life is Tylenol. But it appears that the first drug we are given as infants is sugar.

Does sugar treat pain? For adults, I would say no. I mean, it’s a great distraction and all, but it doesn’t make a dent in actual pain.

I was just thinking about how there’s been a significant reduction in people who smoke cigarettes. Great, right? Then how come Americans are so unhealthy? Could it be that millions of smokers have replaced that addiction with a sugar addiction? No doubt the high cost of cigarettes have caused a lot of people to quit, but did it make us all healthier? Will a ridiculously high sugar tax work the same way? Will that sugar tax affect almost every product we buy?

What addiction will replace our sugar addiction? Something worse?

And now I’m wondering if sugar given in infancy is a trigger for addiction. After all, there are significantly more people addicted to sugar than to other drugs.

(1/25/2016) AAP: Drugs Should Not Be First Option for Babies in Pain

Pharmacologic interventions, such as certain pain relieving medications, should be used only after carefully weighing the risks and benefits of the treatment. Sucrose and glucose should also be treated as pharmacologic interventions, they wrote in Pediatrics.

New research continues to examine the safety and efficacy of nonpharmacologic therapies for infant pain management. A Cochrane review found breastfeeding associated with significantly lower pain responses than positioning, rocking or maternal holding during a heel lance or venipuncture…

Sucrose is often given to infants as analgesia during certain procedures, and authors say its administration should require a prescription and tracking, similar to a medication. A meta-analysis suggested that sucrose is safe and effective for pain reduction during a single event, but the authors note that an optimal dose has not been determined nor has the safety of its long-term use been adequately studied.

“There are ongoing questions about the safety of repeated sucrose and glucose on developmental outcomes later in infancy, and so we still would caution people to be very mindful on how and when they’re using that,” said Keels.

Opioids such as fentanyl and morphine are the most common medications used for newborn pain management, especially for persistent pain. A recent review reported a “limited favorable effect” with selective rather than routine use of opioids in mechanically ventilated infants, as well as insufficient evidence to recommend routine use for these neonates…

The study says that small doses of oral sucrose do not reduce the pain which a baby feels when its heel is pricked to yield a blood sample or it has a drip put in to receive antibiotics.

Its conclusions directly challenge existing medical practice. Infants are routinely given tiny amounts of sugar in hospitals, both in the UK and around the world, as a way of limiting the pain they feel when they undergo short but painful procedures. Sick babies who receive sustained treatment in the early weeks of their lives may receive many doses to help them cope with repeated invasive procedures, which also include having an injection or having blood taken from a vein.

“Our findings indicate that sucrose is not an effective pain relief drug. This is especially important in view of the increasing evidence that pain may cause short and long-term adverse effects on infant neurodevelopment,” said Dr Rebecca Slater, who led the Medical Research Council-funded study at University College London…

Could the potential to suffer from a chronic pain condition be traced back to infancy, when pain was under-treated or ignored?

Babies are usually given a dose of one-tenth of a gram of sucrose, a concentrated sugar solution, into their mouths before a procedure starts because doctors believe that it reduces, but does not remove, the pain involved. Many previous studies have found that the practice works, including a review of all the existing medical literature on it published earlier this year by the authoritative Cochrane Review.

But those studies were flawed because they relied on the change in the baby’s facial expression upon receiving the sugar, from puckered-up to relaxed, as proof that it works, the new study says.

Instead, using different ways of measuring babies’ reactions to the procedures, it has found that infants continue to feel pain, despite receiving the substance, as shown by measurements of the levels of pain activity in their brains and spinal cords after 59 newborns had undergone a routine heel prick test…

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