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Neonatal pain facial expression: evaluating the primal face of pain

Martin Schiavenato1, Jacquie F Byers, Paul Scovanner

  • 1University of Rochester, School of Nursing, 601 Elmwood Ave., Box SON, Rochester, NY 14642-8404, USA College of Nursing, University of Central Florida, Orlando, FL 32816, USA School of Electrical Engineering and Computer Science, University of Central Florida, Orlando, FL 32816, USA Department of Medicine, University of Rochester, Rochester NY 14642, USA Department of Biostatistics and Computational Biology, University of Rochester, Rochester NY 14642, USA.

Pain
|August 12, 2008
PubMed

Insights

The primal face of pain (PFP) is a universal infant pain expression, characterized by specific facial movements. This study confirmed its presence across diverse neonates, regardless of sex or ethnicity.

Area of Science:

  • Neonatal research
  • Pain perception
  • Facial expression analysis

Background:

  • The primal face of pain (PFP) is theorized as an innate, universal facial expression for pain.
  • Previous research suggests neonates exhibit distinct facial responses to painful stimuli.

Purpose of the Study:

  • To evaluate the presence and characteristics of the primal face of pain in a diverse neonatal sample.
  • To determine if sex, ethnicity, feeding type, behavioral state, or perinatal anesthesia influence the PFP.

Main Methods:

  • A computer-based "point-pair" comparison methodology was used to analyze video recordings of neonates before and after a painful heel-stick stimulus.
  • Facial movements associated with pain were measured by analyzing changes between image pairs.
  • The study included 57 neonates from African American, Caucasian, and Hispanic/Latino backgrounds, controlling for feeding type, behavioral state, and anesthesia use.

Main Results:

  • The PFP was observed and is characterized by mouth opening, brow lowering, and eye closure.
  • Facial expressions of pain were consistent with previous reports.
  • No significant clustering or unique displays of the PFP were found based on sex or ethnicity.

Conclusions:

  • The primal face of pain is a common and universal expression in neonates.
  • The PFP appears consistent across different sexes and ethnicities, suggesting a hardwired response.
  • Further research is needed to understand the clinical significance and individual variations in pain displays.

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