Newborns experience too much pain from routine medical procedures, especially premature infants with more intensive health needs, according to a policy statement by the American Academy of Pediatrics (AAP).
Research suggests that repeated exposure to pain early in life can create changes in brain development and the body’s stress response systems that can last into childhood.
Because of this, the AAP policy statement recommends every health facility caring for newborns should use strategies to minimise the number of painful procedures performed, and routinely monitor and treat pain with greater emphasis on proven non-drug interventions.
“The prevention of pain in neonates should be the goal of all paediatricians and health care professionals who work with neonates, not only because it is ethical but also because repeated painful exposures have the potential for deleterious consequences,” wrote Erin Keels, MD, Nationwide Children’s Hospital, Columbus, Ohio, and colleagues.
“Neonates at greatest risk of neurodevelopmental impairment as a result of preterm birth (ie, the smallest and sickest) are also those most likely to be exposed to the greatest number of painful stimuli in the NICU.”
Routinely giving newborns sucrose and glucose to reduce pain during procedures is effective, but there are concerns that excessive use can affect neurological development.
At the same time, the authors said, safe and effective interventions such as skin-to-skin contact and breastfeeding remain underutilised for routine minor, yet painful procedures.
Therefore, every healthcare facility caring for neonates should implement a pain-prevention program and a pain assessment and management plan that includes routine assessment of pain, pharmacologic and non-pharmacologic therapies for the prevention of pain associated with routine minor procedures, and measures for minimising pain associated with surgery and other major procedures.
The policy statement is published online and will appear in the February 2016 print edition of the journal Pediatrics.
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