Ramenghi 1999.

Methods	Randomized, double‐blind, placebo‐controlled, cross‐over trial for the mode of delivery of sucrose or water by mouth or intragastrically Painful intervention: heel lance Study location: Leeds General Infirmary, Leeds, UK Study period: Dates not provided
Participants	30 preterm infants (PMA 32 to 36 weeks, PNA < 24 h)
Interventions	Each infant received either sucrose or water and was not crossed over for the solution received, only for the method of delivery Sucrose group (n = 15): 25% sucrose solution (volume not reported) given via syringe into the mouth or via NG tube 2 min prior to first heel lance, and via the alternate route for the second heel lance within 48 h Water group (n = 15) : sterile water via syringe into the mouth or via NG tube 2 min prior to first heel lance and via the alternate route for the second heel lance within 48 h Cross‐over design
Outcomes	Percentage crying over 5 min after sampling, behavioural scores (4 facial expressions and the presence of cry) at 1, 3 and 5 min after the lance for a total behavioural score
Notes	Mann Whitney‐U and Wilcoxon matched pairs signed ranked test used to evaluate outcomes Results reported as median and IQR and total range Adverse effects were not evaluated
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Sequence generation not described
Allocation concealment (selection bias)	Unclear risk	Allocation concealment not described
Blinding (performance bias and detection bias) All outcomes	Unclear risk	Did not describe measures taken to ensure blinding of intervention and outcome assessment
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Did not describe measures taken to ensure blinding of intervention and outcome assessment
Incomplete outcome data (attrition bias) All outcomes	Low risk	Outcomes reported on all randomized infants
Selective reporting (reporting bias)	Unclear risk	The study protocol was not available to us so we could not judge whether there were any deviations from it
Other bias	Low risk	Appears free of other bias