Pediatricians Seek to Reduce Pain Experienced by Preemies

Last month, the American Academy of Pediatrics released a policy statement on the prevention and management of pain experienced by premature babies.

As AP reports, “It used to be thought that these infants were too young to feel pain. But even now, experts say, pain relief for newborns and especially preemies is often inadequate, despite evidence that low-tech comforting methods and medication can both be effective.” 

The policy notes that premature babies may in fact feel pain more intensely than full-term babies since the inhibitory parts of the pain-sensing nervous system are not yet developed.

The Academy underlines the gravity of this pain in ethical terms and practical terms, noting the consequences of failing to prevent or alleviate pain in preemies: “The prevention and alleviation of pain in neonates, particularly preterm infants, is important not only because it is ethical but also because exposure to repeated painful stimuli early in life is known to have short- and long-term adverse sequelae.”

Newborn specialist Erin Keels of Columbus’ own Nationwide Children’s Hospital was the lead author of the Academy’s policy. She noted that assessing pain in preemies can prove challenging. In busy intensive care units, pain relief for minor procedures can be overlooked. 

New research showing the benefits from alternatives to medications prompted the Academy’s new policy. Among those alternatives are skin-to-skin contact with moms and dads, a practice that Nationwide Children’s is celebrating as “Kangaroo Care” during the month of May.

As the American Academy of Pediatrics holds hospitals accountable for responding to the pain experienced by preemies, they are setting a standard that we would all do well to follow when it comes to protecting children from pain. 

For several decades now, neonatal experts have been analyzing neonates’ pain and pursuing ways to minimize it. A generation ago, newborns routinely underwent surgery without anesthesia. But now, anesthesia has become routine for both neonatal and fetal surgery, thanks to Dr. Kawaljeet Anand, who in the early 1980s, noticed many neonatal patients exhibiting stress and even dying after surgery. Anand proved that babies were feeling pain—and dying from it. In one study, mortality dropped from 25 to 10 percent just by using anesthesia.

Almost a year ago, Ohio Right to Life submitted 70 studies to the Senate Committee on Health and Aging, confirming that pre-born babies begin feeling pain as late as 20 weeks gestation. Indeed, pain receptors are present throughout the baby’s body by that point, though they first appear around 6-7 weeks gestation and babies respond to touch at just 8. The Academy’s new policy is based on research of preemies as young as 25 weeks.

Premature babies show us the wonder and vulnerability of the human child long before birth. They challenge us to see the intrinsic value and dignity of the human child regardless of size, level of development, and location. They move us to action. In particular, they move the tremendous work of the medical community to respond with empathy to their pain and their fragility.

Our responsiveness to the pain experienced by the most vulnerable among us is indeed reflective of our compassion, our integrity, and our strength in making decisions that protect and advance the lives of the smallest among us. 



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