33 children (131 castings) with idiopathic clubfoot were randomized to one of three treatments aiming to decrease neonatal pain response during Ponseti manipulation: (1) 20% oral sucrose solution, (2) bottled milk (breast/non-breast), or (3) water. The purpose of this study was to determine which treatment resulted in the greatest decrease in neonatal pain response, while additionally measuring heart rate and oxygen saturation before, during, and after-casting. Results demonstrated that patients who were given sucrose or milk registered a significantly decreased pain response during casting when compared to patients who received water. Patients in the sucrose group additionally demonstrated a significantly decreased pain response after casting was completed when compared to the other study groups.