The first time parents hear their newborn cry, they often cry too — tears of happiness, of course, that their child has officially arrived in the world and is, by the sound of those lungs, healthy.
But after that, baby crying gets more complicated. Is she hungry? Tired? Uncomfortable? Wanting to be held? Or, most dreaded, in pain? “Until they can talk, it’s hard to know,” says Kenneth Gorfinkle, a psychologist at Common Sense Therapy in New York City and author of “Soothing Your Child’s Pain: From Teething to Tummy Aches to Acute Illnesses and Injuries.” “There’s a lot of guessing.”
But one thing parents don’t have to guess about is whether their newborn even can feel pain — something that doctors and researchers haven’t always been sure about. “What was thought (a few decades ago) was that babies, before they could start speaking, couldn’t really experience complex emotions and feelings — that they were primitive beings; that if they couldn’t talk about it, they didn’t experience it,” Gorfinkle says. “That couldn’t be farther from the truth.”
In reality, research co-led by Rebeccah Slater, a professor of pediatric neuroscience at the University of Oxford in England, suggests that the pain response develops as early as 35 to 37 weeks gestation, or just before a full-term baby is born. Here are more answers to common questions about babies and pain:
[See: On a Scale From 1 to 10: Most Painful Medical Conditions.]
Why Do Babies Feel Pain?
Though it seems unfair in a person so helpless, the perception of pain can serve a purpose. “The perception of pain causes infants to cry, which can attract the attention of parents or care providers who can then help alleviate the pain,” Slater says. “If a baby needs a painful procedure, such as an injection, they will reflex their limbs away from the stimulus, which can be protective too.” At the very least, take comfort in knowing that having a pain perception early on is part of normal, healthy development. Just like your baby has nails but can’t yet scratch and legs but can’t yet walk, “a lot of traits don’t function with their intended use until later on in life,” Gorfinkle says.
What Does Pain Feel Like to Babies?
Just like it’s impossible to know exactly how your spouse feels when he complains of an achy back since pain is subjective and involves multiple pathways, there’s no way to know precisely what your baby is going through when he or she is in pain, experts say. However, research also conducted by Slater and colleagues using brain imaging techniques has shown that the brain response is similar to that in adults. When newborns are poked in the foot with a thin rod, the researchers found, their brains light up in nearly all the same areas that adult brains do when subjected to a comparable prod. “This strongly supports the hypothesis that infants are able to experience both sensory and (emotional) aspects of pain,” the study authors concluded.
Do Some Babies Have Lower Pain Tolerances Than Others?
Infants, like the children and adults they’ll become, all have different temperaments. Some might be quick to wail and others may seem tougher — it’s all normal human variation, Gorfinkle says. That said, premature babies are most at risk for experiencing pain, both because their underdeveloped brains may be more sensitive to it and their precarious condition makes them likely to be exposed to potentially painful stimuli like IV sticks and blood draws. “All of those things that are part of normal care probably do generate a physiologic response as it relates to pain,” says Dr. Ira Adams-Chapman, a neonatologist at Children’s Healthcare of Atlanta, which is affiliated with Emory University, and member of the American Academy of Pediatrics’ Committee on Fetus and Newborn.
How Is Pain Treated in Babies?
Managing babies’ pain is not only ethical, but it also helps prevent developmental problems later in life, reports the AAP. “In older children, we know that exposure to recurrent or chronic pain causes long-term consequences, so we speculate the same is true for babies,” says Adams-Chapman, also an assistant professor of pediatrics at Emory University School of Medicine. For instance, they might develop sensory issues, including a heightened sensitivity to pain, in childhood.
And while some reports suggest treatments for pain relief may still be underused, researchers and clinicians continue to develop — and use — therapies ranging from swaddling and offering something like a pacifier to suck on to non-steroidal anti-inflammatory medications and local anesthesia. Child life specialists, a relatively new profession, may also use research-backed non-pharmacological tactics like singing and distraction. “We have a lot more weapons in our arsenal to choose from in terms of addressing neonatal pain,” Adams-Chapman says. The goal, she adds, is to minimize the risk of medication complications and side effects while maximizing infants’ comfort.
[See: 4 Opioid Drugs Parents Should Have on Their Radar.]
How Can Parents Tell if Their Baby Is in Pain?
While clinicians use tools to measure a baby’s heart rate, breathing rate and other vital signs that can indicate pain, parents need to tune into their baby’s behaviors to suspect pain, although differentiating pain from other issues like hunger or sleepiness takes trial and error, Gorfinkle says. Some signs the discomfort is actually pain include higher-pitched or difficult-to-soothe crying, grimacing facial expressions, tense or squirmy posture and general irritability, according to the University of Michigan Health System.
What Can Parents Do to Ease Their Baby’s Pain?
Fortunately, parents can play an important role in helping to prevent, manage and soothe their little ones’ pain. “Parents are part of the health care team,” Adams-Chapman says. Here are some strategies experts suggest:
— Touch your baby. Often, loving touch is medicinal for babies. One recent study showed that gently stroking an infant — brushing about 3 centimeters per second, to be exact — can reduce his or her brain activity associated with pain. “Touch-based interventions are known to have other beneficial effects, such as decreasing infant and parent stress levels, and increasing infant-parent bonding, as well as preventing or soothing pain,” says Deniz Gursul, a doctoral student in the University of Oxford’s department of pediatrics who led the study. Other techniques that come naturally to parents — singing to, gently massaging and cuddling their children — also help ease pain. “In many ways, this is ancient knowledge that medicine forgot,” Gorfinkle says.
[See: 10 Things Pediatricians Advise and Parents Ignore and Really Shouldn’t Shouldn’t.]
— Breastfeed if possible. A meta-analysis of 20 studies found that breastfeeding significantly lowered pain in infants (according to their heart rates and how long they cried) compared to other non-drug therapies like rocking and holding. The effect was similar to being given a sugar solution, a common pain relief technique for babies undergoing minor, but potentially painful, procedures. Parents who can’t breastfeed may talk to their doctors about giving their babies a sugar solution (so long as it’s not honey, which can cause botulism in infants) on a pacifier, or a properly-dosed over-the-counter pain reliever.
— Relax. As hard as it may be, acting relaxed while holding your baby can also help accelerate your baby’s pain relief. “Babies are very perceptive of their own parents,” Gorfinkle says, sensing things like muscle tension and potentially even changes in the scent you give off. “You want to convey a sense of comfort and relaxation.” Need a reason to relax, or at least fake it? Pain that comes from necessary medical procedures — whether a routine vaccine or an invasive surgery — is worth the cost. “Parents are upset at the thought that they were unable to protect their child from pain, even if it means getting life-saving medical treatment,” Gorfinkle says. “We try to tell them they’re doing a good thing for their child.”
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How to Tell If Your Baby Is in Pain — and What to Do About It originally appeared on usnews.com
