We use Sweet-ease for brief procedures (lab draw/IV start) lasting less than a few minutes long. I think we have to use it within 1 minute before the procedure. Also have to document it as a pain intervention, pain score, and follow up pain score after the fact.
Personally I do not use them with infants who have suspected abdominal issue/NEC/etc. Others say it 'absorbs into the subglossal membranes only' but I don't really want to take the risk. To each their own I suppose.
Sweet-ease are not to be used for a crying/fussy infant.... Although sometimes I wish it was allowed for those term/NPO babies, but don't we all?
Our facility recently changed our policy on Sweet Ease.
We can use it, under protocol, for IV starts, circumcisions, infants that are NAS, whether or not replacement therapy is still continuing....and for any infant having a wound that is healing, dressing change, etc.
Other than that, it requires an order, but I can't imagine when else it would be used.
Short term procedural pain as mentioned by others except we do not use it for neonatal abstinence syndrome babies (I suppose to not mask the effects of their withdrawal medication). Lab sticks, IV sticks, circumcision are our main uses. We have used it for helping with PICC placement and with wound dressing changes. We do not use it for babies who are NPO/NEC (the high osmolarity is bad for their gut) or are less than 32 weeks without an order (same gut reason I think as well as their swallowing/gag reflex ability... it has to be placed on the tip of their tongue to actually work.). We use 10 pacifier dips for term babies (38+ weeks) and 5 dips for preemies and apply it to the tip of their tongue and wait 2 minutes before starting the painful procedure. We also use swaddling whenever possible and keeping lights low (cover their eyes from lights with a cloth, etc.) during the procedure. We are not supposed to use it more often than once every 6 hours, we must discard the container after using it (not keep it at bedside since the pacifier has mouth bacteria on saliva which can grow in the sugar in the SweetEase. We never use it to soothe a fussy baby for fear of masking an actual problem that needs addressing. Also it only works best for the first 30 days of life or so I think...