The most common causes of neonatal pain include circumcision, trauma during birth, infection and procedures necessary to treat it, and pain following infant surgeries. If an infant requires breathing or feeding tubes because of a medical condition at birth, it can cause neonatal pain that can be addressed. Injections, intravenous lines, or any other procedure that breaks the skin usually cause pain in the neonate. Some infants experience painful colic that generally eases after three months.
Babies born prematurely or with a serious medical condition at birth commonly receive treatment in a neonatal intensive care unit. Several of the procedures used in these specialized units result in neonatal pain that can be assessed and treated. Acute pain might come from more than a dozen procedures a day to regulate the infant’s breathing and heart rate. If the baby has undergone surgery for a birth defect, post-surgical pain is likely.
Infection, or sepsis, can infect a neonate before birth or within 28 days after birth. Obstetricians commonly screen pregnant women for signs of infection throughout their pregnancies. Abnormalities in the fetal heart beat or respiration might indicate a viral or bacterial infection. In severe cases, a baby might be born too sick to nurse or breathe independently, which may require a feeding tube and ventilation device.
Assessment of neonatal pain can be difficult because the infant is unable to communicate with caregivers. Doctors and nurses generally use assessment tools to determine if a baby is in pain or simply agitated. These observations measure physical signs that might indicate neonatal pain, along with a general understanding that a procedure that causes pain for an adult likely causes pain in infants.
Changes in heart rate and blood pressure typically indicate pain. If the infant is sweating, unable to sleep, and persistently crying, an assessment for pain is usually conducted. An infant suffering discomfort might also clench his or her hands, and his or her arms and legs may flex. The baby may also become red in the face and show tension in his or her muscles.
Treatment for infant pain includes local anesthetics used before a painful procedure, like circumcision, is performed. If pain appears minor, acetaminophen can be administered to ease the baby’s discomfort. For chronic pain, especially after surgery, morphine and other drugs are commonly used in neonatal intensive care units. Caregivers also attempt to reduce or avoid painful procedures unless they are absolutely necessary.
Non-medical techniques might also ease pain. Some infants respond positively to a quiet room with low lighting after a painful procedure. Others receive comfort from swaddling or rocking. Intensive care nurses commonly use pacifiers, or direct a baby’s thumb to his or her mouth to comfort a child who shows symptoms of pain.
Caregivers commonly attempt to dispel myths regarding neonatal pain. Some people believe there is no way to determine if an infant suffers pain because babies cannot communicate. Observational and physical tools that evaluate neonatal pain might disprove this theory.
