Comparison 1. Pain response during skin puncture to VP vs. HL in infants who did not receive a sweet tasting solution.

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Behavioural pain scores for VP vs. HL	5	288	Std. Mean Difference (IV, Fixed, 95% CI)	‐0.76 [‐1.00, ‐0.52]
1.1 NIPS score	2	81	Std. Mean Difference (IV, Fixed, 95% CI)	‐0.93 [‐1.40, ‐0.47]
1.2 NFCS score	2	147	Std. Mean Difference (IV, Fixed, 95% CI)	‐0.71 [‐1.05, ‐0.38]
1.3 PIPP score	1	60	Std. Mean Difference (IV, Fixed, 95% CI)	‐0.67 [‐1.19, ‐0.15]
2 Duration of first cry (seconds)	1	50	Mean Difference (IV, Fixed, 95% CI)	‐112.0 [‐163.99, ‐60.01]
3 Total duration of cry (seconds)	1	100	Mean Difference (IV, Fixed, 95% CI)	‐188.0 [‐228.42, ‐147.58]
4 Number of neonates who cried during the procedure	3	207	Risk Difference (M‐H, Fixed, 95% CI)	‐0.35 [‐0.46, ‐0.23]
5 First crying time (seconds)/total procedure time (seconds) (%)	1	50	Mean Difference (IV, Fixed, 95% CI)	‐65.0 [‐110.12, ‐19.88]
6 Duration of cry in the first three minutes after skin puncture	1	60	Mean Difference (IV, Fixed, 95% CI)	‐106.0 [‐128.52, ‐83.48]
7 Sampling time (seconds)	1	50	Mean Difference (IV, Fixed, 95% CI)	‐65.0 [‐109.93, ‐20.07]
8 Need for more than one skin puncture	4	254	Risk Ratio (M‐H, Fixed, 95% CI)	0.29 [0.18, 0.46]
9 Need for more than two skin punctures	1	60	Risk Ratio (M‐H, Fixed, 95% CI)	5.0 [0.62, 40.28]
10 Brusing/hematoma at local site	3	137	Risk Ratio (M‐H, Fixed, 95% CI)	0.36 [0.02, 8.06]
11 Maternal anxiety score prior to the procedure	1	27	Mean Difference (IV, Fixed, 95% CI)	0.80 [0.34, 1.26]
12 Infant's pain score as rated by the mother	1	27	Mean Difference (IV, Fixed, 95% CI)	‐0.80 [‐1.18, ‐0.42]