Newborns with fetal and neonatal alloimmune thrombocytopenia (FNAIT) can require repeated blood sampling to monitor platelet levels, and an overview of evidence published recently in Paediatric & Neonatal Pain found that sucrose and skin-to-skin contact can reduce pain from these procedures.
These findings suggest that simple, family-centered approaches could help make necessary blood tests more comfortable for newborns.
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“This overview is comprehensive, including both pharmacological and non-pharmacological interventions,” the authors wrote. “This allows a wide range of intervention options to be considered for families, depending on the circumstance.”
Researchers searched four databases for systematic reviews published between 2014 and April 2026. Of 2,463 records identified, 22 reviews met the criteria, including 13 Cochrane reviews, two non-Cochrane reviews and seven network meta-analyses. The reviews included eight to 105 randomized or quasi-randomized controlled trials and 506 to 7049 participants. They examined medications, topical anesthetics, breastfeeding or breast milk, sucrose, music, acupuncture and other non-drug approaches.
Sucrose, given alone or with a pacifier or other sucking, helped reduce pain from heel pricks in both premature and full-term newborns. It also reduced pain after blood draws from a vein, although the evidence was stronger for some outcomes than others. This may be particularly relevant for babies with FNAIT, who may need repeated blood tests to monitor platelet levels.
Read more about FNAIT treatment and care
Skin-to-skin contact also helped ease pain during and after heel pricks. Newborns held against a parent’s bare chest had lower pain scores and cried for about 34 seconds less than babies who did not receive skin-to-skin contact. For families dealing with FNAIT, these findings suggest that a parent may be able to provide some comfort during blood sampling simply by holding the baby skin-to-skin, when the baby’s medical condition allows it.
Breastfeeding and expressed or supplemental breast milk appeared helpful as well, although the evidence was generally less certain. Network meta-analyses similarly found benefits from parent-led approaches, oral sweet solutions and some combinations of touch, sucking, sound and other sensory stimulation. Acupuncture, reduced lighting and breast milk odor also showed potential benefits but require more research.
For families of newborns with FNAIT, the findings support asking the neonatal care team about pain-relief measures before blood draws. They do not mean every newborn will need the same approach, and some interventions, including opioids, paracetamol and topical anesthetics, had insufficient or inconsistent evidence specifically for blood sampling. Overall, the evidence favors incorporating sucrose, skin-to-skin contact and other feasible parent-led strategies into routine, family-centered neonatal pain care.
