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Pain in the very preterm baby: 'suffer little children?'
1Department of Psychology, Glasgow Caledonian University, Scotland.
Insights
Very preterm infants, despite their immaturity, can feel pain during Neonatal Intensive Care Unit (NICU) procedures. This pain may be experienced more intensely and have serious consequences, highlighting the need for effective pain management.
Area of Science:
- Neonatalogy
- Developmental Neuroscience
- Pediatric Pain Management
Background:
- Medical advances increase survival rates for very preterm infants, creating a growing population requiring intensive care.
- Very preterm infants possess sensory and learning capabilities comparable to fetuses and full-term babies by 23 weeks gestation.
- Neonatal Intensive Care Units (NICUs) provide life support but expose these vulnerable infants to frequent, potentially painful procedures.
Purpose of the Study:
- To review the evidence on pain perception in very preterm infants.
- To highlight the potential for intense pain experience and serious consequences of medical procedures in this population.
- To emphasize the importance of pain and distress alleviation for very preterm infants.
Main Methods:
- Review of scientific literature from the past 10 years on pain perception in newborns.
- Analysis of studies comparing sensory and developmental abilities across fetal, full-term, and preterm infants.
- Inclusion of findings from rat pup studies on pain intensity in immature mammals.
Main Results:
- Newborns possess developed neurochemical, anatomical, and functional systems capable of perceiving pain.
- Very preterm infants may experience pain more intensely than more mature infants.
- Repeated painful medical interventions can lead to serious adverse consequences.
Conclusions:
- Very preterm infants are sentient beings capable of experiencing pain.
- Pain management is a critical issue in the care of very preterm infants.
- Further research and clinical strategies are needed to mitigate pain and distress in this population.
Abstract:
Increases in medical expertise and technological advances have enabled the survival of very preterm babies who form a new and growing population. Comparisons between the foetus, full-term baby and the very preterm baby indicate that by the time the foetus is of 23 weeks gestation, many of the abilities, for example, sensing touch, hearing, seeing, moving and even learning may be common to all three. Thus, the very preterm infant who has been described as a unique organism, is not passive, but is a sentient being who is unlikely to survive without the medical and technical support of the Neonatal Intensive Care Unit (NICU) where he/she is exposed to frequent and regular medical procedures. Many of these procedures would be, for any normal, fully developed human being at best uncomfortable and at worst painful. Reviews within the past 10 years have shown that the neurochemical, anatomic and functional systems of newborns are developed enough to perceive pain. More importantly, rat pup studies have indicated that not only may the very preterm baby experience pain but it may experience it more intensely than the more mature infant. Moreover, there may be serious consequences of repeated painful medical intervention. Alleviation of pain and/or distress in very preterm infants is, therefore, an important issue.