Managing pain when preemies can’t say "Ouch!"

Premature babies, or infants admitted in the neonatal intensive care unit, most often go through as many as 62 painful procedures each day. Anyone seeing these children being pricked, stubbed, and poked would likely cry “Ouch! STOP!”. Since an infant can’t say anything yet, one would at least expect some form of reaction – the eyebrows bulging, eyes squeezing or other facial expression indicating pain.

However a recent study has revealed heartbreaking news: Because a premature baby still has immature and uncoordinated facial muscles, the facial expressions may not accurately show the level of discomfort the infant is actually feeling. A pain response occurs in the brain, but not on the face.

What’s even more dramatic is this study that showed neonates in intensive care units who undergo painful procedures rarely receive analgesia! This practice is so callous given that sensitivity to pain is highest in the first four weeks of life.

The researchers and the American Academy of Pediatrics recommend drastic changes in clinical practice involving premature infants, including reducing the number of unnecessary lab tests and bundling tests together.

image: sxc