Anesthetic cream best for relieving vaccination pain in infants

For babies under age 1 year, lidocaine cream, combined with a small amount of sugar given by mouth and infant soothing, can help relieve pain from routine vaccinations, according to a study in CMAJ (Canadian Medical Association Journal).

"Vaccinations cause acute distress for both infants and their parents, contributing to vaccination avoidance," states Dr. Anna Taddio, a pharmacist and senior associate scientist at The Hospital for Sick Children (SickKids) and professor, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario. "However, there are gaps in knowledge about what is the best way to alleviate pain during vaccination."

To address this gap, researchers conducted a randomized controlled trial including 352 healthy infants from 3 pediatric outpatient clinics, including 7 physician practices, who received scheduled vaccinations in their first year of life. The infants were randomized to 1 of 4 groups: placebo control; video instruction to parents on how to soothe their baby; video plus oral sugar solution; and video, oral sugar solution and lidocaine applied to the skin.

"We found that, when used consistently during vaccine injections in the first year of life, only liposomal lidocaine combined with parental video instruction and orally administered sucrose showed a benefit on acute pain when compared with placebo, video alone, and video and sucrose together," wrote the authors.

"The effects of consistent pain management on the development of preprocedural anxiety (fear), hypersensitivity to pain and compliance with future vaccination warrant future investigation," they recommend.