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The reality of neonatal pain

Mary Puchalski1, Pat Hummel

  • 1Perinatal Center, Loyola University Chicago, Neonatal Intensive Care Unit, Developmental Follow-up Program, Department of Pediatrics, Loyola University Medical Center, Maywood, IL, USA. mpuchal@lumc.edu

Insights

Neonatal pain is often undertreated due to misconceptions about infant pain perception. Emerging evidence shows infants remember pain, impacting future responses and long-term neurodevelopment.

Area of Science:

  • Neonatal care
  • Neuroscience
  • Developmental pediatrics

Background:

  • Historically, neonatal pain has been unrecognized and undertreated.
  • Misconceptions persist regarding infants' capacity to feel, remember, and express pain.
  • Beliefs that infants do not experience pain like adults contribute to undertreatment.

Purpose of the Study:

  • To describe the embryology of pain in neonates.
  • To discuss emerging evidence of infant pain memory and its implications.
  • To identify and discuss the long-term adverse effects of unrelieved neonatal pain on neurodevelopment.

Main Methods:

  • Review of embryological development of pain pathways.
  • Synthesis of current research on infant pain memory.
  • Analysis of studies detailing long-term neurodevelopmental outcomes following neonatal pain exposure.

Main Results:

  • Infants possess the capacity to feel and remember pain.
  • Repeated painful experiences can lead to permanent structural and functional changes in the infant's brain and spinal cord.
  • Unrelieved neonatal pain is associated with adverse neurodevelopmental outcomes.

Conclusions:

  • Enhanced understanding of infant pain perception is crucial.
  • Recognizing infants' ability to remember pain is essential for appropriate care.
  • Addressing neonatal pain effectively is vital for optimizing short- and long-term neurodevelopmental outcomes.

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