Use our account feature to register for a free CLI account. Your new account will allow you to bookmark and organize articles and research for easy reference later - making it simple to keep track of the research that's important to you!
Register / Sign in
close-panel

Charlotte Lozier Institute

Phone: 202-223-8073
Fax: 571-312-0544

2776 S. Arlington Mill Dr.
#803
Arlington, VA 22206

Get Notifications

Sign up to receive email updates from Charlotte Lozier Institute.

Become A Defender of Life

Your donation helps us continue to provide world-class research in defense of life.

DONATE

Charlotte Lozier Institute

Phone: 202-223-8073
Fax: 571-312-0544

2776 S. Arlington Mill Dr.
#803
Arlington, VA 22206

Fetal Development

Pediatricians Recommend More Attention to Pain Management in Premature Infants

The American Academy of Pediatrics (AAP) has released a statement pertaining to the prevention and management of procedural pain in babies.  Pain that newborns experience from routine medical procedures can be significant, especially in premature infants with more intensive health needs.  Research suggests that repeated exposure to pain early in life can create changes in brain development and the stress response systems that can last into childhood.  Premature infants are especially at risk.  The AAP policy statement recommends that every health facility caring for newborns use strategies to minimize the number of painful procedures performed, and routinely monitor and treat pain with greater emphasis on proven non-drug interventions. The policy statement, “Prevention and Management of Procedural Pain in the Neonate: An Update,” appeared in the February 2016 issue of Pediatrics (published online Jan. 25).

Premature infant
Premature infant [Public domain]

As noted in the AAP statement, pain pathways are “active and functional as early as 25 weeks’ gestation” and premature newborns thus may have a generalized or even an exaggerated response to pain.  The repetition of sensory stimuli can be physiologically stressful, particularly in these sensitive preterm infants.  Investigators demonstrated that even simple procedures, such as routine heel puncture for blood draw or tape removal from the skin, can adversely affect future pain perception.  The cortical pain processing that occurs in preterm and term infants is affected by multiple factors involving excitatory and inhibitory feedback mechanisms.

 

The AAP strongly recommends using the neonatal pain assessment tools, which have been proven to be reliable and reproducible.  A number of rating scales factor prematurity into the pain rating system.  In addition to these observation assessments, new technologies to measure neonatal pain are being investigated, including near-infrared spectroscopy, amplitude-integrated electroencephalography, functional MRI, and heart rate variability assessments.  Most of the tools used to measure acute pain in neonates use a combination of physiologic and behavioral signs to gauge pain levels.  Published studies using current rating scales included infants from 23 weeks prematurity through 2 months of age.  These studies support the existence of pain in infants midway through gestation and beyond.

 

The AAP recommends routine pain management during procedures such as circumcision, chest drain insertion and removal, and nonemergency intubations.  More studies of the dosing and long-term effects of analgesics in the newborn period are needed. As the AAP states, there is a critical need to achieve adequate pain control in newborns, “both as an ethical duty and because painful experiences in the NICU can have long-term adverse effects.”  Preventing or minimizing pain in neonates should be the goal of pediatricians and other health care professionals who care for babies.

 

Colleen Malloy, M.D. is Associate Professor in Clinical Pediatrics/Neonatology, Ann & Robert H. Lurie Children’s Hospital of Chicago and Northwestern University Feinberg School of Medicine.

 

Latest Posts

March 25, 2024 Filed: CLI Amicus Brief in Idaho’s Moyle v. United States EMTALA Case March 22, 2024 Fact Sheet: Three Problems with the FDA’s Abortion Drugs Complications Data March 21, 2024 Filed: CLI Amicus Brief in SCOTUS Case FDA v. Alliance for Hippocratic Medicine

You Might Also Be Interested In

Five Facts About “Life-Limiting” Fetal Conditions

charlotte-lozier-institute Charlotte Lozier Institute
February 15, 2024
ClosePlease login

Tara Sander Lee | “Knit Together in a Mother’s Womb”

August 13, 2023
ClosePlease login

12 Facts at 12 Weeks

charlotte-lozier-institute Charlotte Lozier Institute
April 25, 2023
ClosePlease login

Become A Defender of Life

Your donation helps us continue to provide
world-class research in defense of life.

BECOME A PARTNER
cta-image