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Pain and Analgesia in Newborns-Development of a Neonatal Pain Ladder

Jacob V Aranda1, Victoria Tutag Lehr2, John N van den Anker3

  • 1Division of Neonatology, State University of New York, Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY 11203, USA.

Clinics in Perinatology
|August 5, 2026
PubMed

Insights

Preventing and relieving pain in newborns is crucial for their development. Routine pain assessment and a proposed intervention ladder can guide appropriate care, improving infant outcomes.

Area of Science:

  • Neonatal care
  • Pediatric pain management
  • Neurodevelopmental outcomes

Background:

  • Untreated neonatal pain can lead to adverse short- and long-term consequences, including neurodevelopmental impairment.
  • Effective pain management in newborns is a critical ethical and humane consideration.
  • Routine assessment and awareness of pain are essential for guiding interventions.

Purpose of the Study:

  • To highlight the importance of preventing and relieving pain in newborns.
  • To propose a structured approach for managing neonatal pain.
  • To emphasize the role of pain assessment in guiding therapeutic interventions.

Main Methods:

  • Review of current practices in neonatal pain management.
  • Proposal of a 'Pain and Analgesics In Newborns' ladder for tiered interventions.
  • Advocacy for routine recording of pain intensity scores as vital signs.

Main Results:

  • Unrelieved pain in newborns can result in significant negative health outcomes.
  • A structured approach can help tailor interventions to pain severity.
  • Validated pain scoring tools, despite subjectivity, are vital for assessment.

Conclusions:

  • Routine pain assessment and the proposed intervention ladder can optimize neonatal care.
  • Integrating pain scores as vital signs can improve pain management strategies.
  • Prioritizing pain relief in newborns is essential for promoting comfort and better long-term outcomes.

Keywords:
AnalgesicsAssessmentNewbornPainPain ladderSedatives

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