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Pain Relief for Infants: Understanding and Managing Baby Discomfort

by alexxlab

How do infants experience pain. What are the signs of discomfort in babies. How can parents and healthcare providers effectively manage infant pain. What non-medicinal methods can be used to alleviate baby discomfort. Why is proper pain management crucial for infants.

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The Reality of Infant Pain: Dispelling Myths and Recognizing Symptoms

For many years, it was widely believed that infants didn’t experience pain in the same way adults do. However, modern research has conclusively shown that babies do indeed feel pain, and their pain can be effectively treated. Understanding this reality is crucial for parents and healthcare providers alike.

How do we know that infants feel pain? While babies can’t verbalize their discomfort, they exhibit various behavioral and physiological signs that indicate pain. These include changes in sleep patterns, irritability, restlessness, decreased appetite, altered movement, and fluctuations in vital signs such as heart rate, breathing rate, and blood pressure.

Common Signs of Pain in Infants

  • Robust, high-pitched crying that lasts longer than usual
  • Facial expressions: furrowed brow, squeezed eyes, quivering chin
  • Muscle tension: clenched fists, rigid body, or flailing limbs
  • Irritability and restlessness
  • Refusal to eat or difficulty sleeping
  • Changes in movement patterns

It’s important to note that each infant may respond differently to pain, and their reactions can be inconsistent. Some very sick or premature babies might become silent or lose muscle tension when in pain, making it even more crucial for caregivers to be vigilant and observant.

Common Causes of Pain in Infants: From Medical Procedures to Everyday Discomforts

Understanding the various sources of pain in infants is essential for effective management and prevention. Pain in babies can stem from a wide range of causes, both medical and environmental.

Medical Causes of Infant Pain

  • Post-surgical pain from incisions, tissue stretching, or swelling
  • Procedural pain from IV insertions or blood draws
  • Nerve pain from tissue damage or inflammation
  • Infections causing generalized achiness
  • Discomfort from medical tubes or devices

Environmental and Physical Causes

  • Prolonged immobility leading to muscle soreness
  • Skin abrasions or pressure sores
  • Digestive discomfort from gas or reflux
  • Teething pain
  • Temperature extremes causing discomfort

By recognizing these potential pain sources, caregivers can be more proactive in addressing and preventing infant discomfort. How can healthcare providers effectively identify the cause of an infant’s pain? A comprehensive assessment involving physical examination, medical history review, and observation of the baby’s behavior is typically employed to pinpoint the source of discomfort.

The Crucial Role of Parents in Infant Pain Management

Parents play an indispensable role in managing their baby’s pain. As the individuals who know their child best, parents are uniquely positioned to work alongside healthcare professionals to ensure optimal pain management for their infant.

How Parents Can Contribute to Pain Management

  1. Be present during medical procedures or difficult situations
  2. Communicate with healthcare staff about perceived pain levels
  3. Advocate for pain medication adjustments when necessary
  4. Employ calming techniques such as gentle patting, massaging, or rocking
  5. Use a soothing voice to comfort the baby
  6. Maintain skin-to-skin contact when possible

Why is parental involvement so crucial in infant pain management? Parents provide a sense of security and familiarity for the baby, which can significantly reduce stress and anxiety associated with pain. Additionally, parents are often the first to notice subtle changes in their baby’s behavior that might indicate discomfort.

How can healthcare providers better integrate parents into the pain management process? Encouraging open communication, providing education on pain assessment techniques, and involving parents in decision-making regarding pain management strategies can foster a more collaborative and effective approach to infant care.

Non-Medicinal Approaches to Infant Pain Relief: Gentle and Effective Strategies

While medication plays a vital role in managing severe pain, non-medicinal approaches can be highly effective for mild to moderate discomfort and as complementary strategies to pharmaceutical interventions. These methods focus on creating a soothing environment and providing comforting sensations for the infant.

Environmental Modifications

  • Reducing ambient light levels
  • Minimizing noise and activity around the baby
  • Maintaining a comfortable room temperature

Physical Comfort Techniques

  • Offering a pacifier for non-nutritive sucking
  • Administering small amounts of sugar water (24% sucrose solution)
  • Providing skin-to-skin contact or “Kangaroo Care”
  • Swaddling or containment holding
  • Gentle rocking or rhythmic movement

Distraction and Sensory Stimulation

  • Using soothing voices, music, or singing
  • Telling stories or reciting nursery rhymes
  • Providing age-appropriate visual stimuli

How effective are these non-medicinal approaches in managing infant pain? Research has shown that these techniques can significantly reduce pain perception and distress in infants, particularly during minor procedures or for ongoing discomfort. When used in combination with appropriate medical interventions, they form a comprehensive pain management strategy.

Can non-medicinal pain relief methods be used for all types of infant pain? While these techniques are generally safe and can be widely applied, it’s essential to consult with healthcare providers to ensure they are appropriate for the specific situation and don’t interfere with necessary medical treatments.

The Children’s Comfort Promise™: A Comprehensive Approach to Pediatric Pain Management

The Children’s Comfort Promise™ represents a commitment to providing the highest standard of pain management for young patients. This initiative recognizes pain relief as a fundamental right for infants and children, emphasizing a multidisciplinary approach to pain and anxiety management.

Key Principles of the Children’s Comfort Promise™

  • Prioritizing pain prevention and treatment
  • Utilizing both medicinal and non-medicinal therapies
  • Employing a team-based approach to pain management
  • Encouraging collaboration between staff and families
  • Emphasizing prompt pain assessment and effective treatment

How does the Children’s Comfort Promise™ benefit infants and their families? By establishing a comprehensive framework for pain management, this initiative ensures that all aspects of a child’s comfort are considered and addressed. It promotes a culture of empathy and proactive care within healthcare settings.

What impact has the Children’s Comfort Promise™ had on pediatric pain management practices? Since its implementation, healthcare facilities adopting this approach have reported improved patient outcomes, increased parent satisfaction, and enhanced staff awareness of pain management techniques. It has also spurred further research and innovation in the field of pediatric pain relief.

Assessing Pain in Infants: Challenges and Strategies for Accurate Evaluation

Accurately assessing pain in infants presents unique challenges due to their inability to verbalize their experiences. Healthcare providers and parents must rely on a combination of behavioral cues, physiological indicators, and standardized assessment tools to gauge an infant’s pain level.

Behavioral Pain Indicators

  • Facial expressions (e.g., grimacing, furrowed brow)
  • Body movements and postures
  • Crying patterns
  • Changes in sleep-wake cycles
  • Alterations in feeding behavior

Physiological Pain Indicators

  • Increased heart rate
  • Elevated blood pressure
  • Faster breathing rate
  • Changes in oxygen saturation levels
  • Hormonal stress responses

What standardized tools are available for assessing infant pain? Several validated pain scales have been developed specifically for infants, including:

  • NIPS (Neonatal Infant Pain Scale)
  • PIPP (Premature Infant Pain Profile)
  • FLACC (Face, Legs, Activity, Cry, Consolability) Scale
  • N-PASS (Neonatal Pain, Agitation and Sedation Scale)

How can healthcare providers improve their accuracy in assessing infant pain? Regular training in pain assessment techniques, consistent use of standardized tools, and close collaboration with parents can enhance the ability to recognize and quantify pain in infants. Additionally, considering the infant’s individual baseline behavior and medical context is crucial for accurate pain evaluation.

The Long-Term Impact of Unmanaged Infant Pain: Why Early Intervention Matters

The importance of effectively managing infant pain extends far beyond immediate comfort. Research has shown that inadequately treated pain in infancy can have lasting effects on a child’s development and future pain perception.

Potential Long-Term Consequences of Unmanaged Infant Pain

  • Altered pain thresholds and sensitivity
  • Increased risk of chronic pain conditions
  • Impaired cognitive and motor development
  • Behavioral and emotional difficulties
  • Stress-related physiological changes

How does early pain experience affect an infant’s developing nervous system? Repeated or prolonged pain exposure during critical developmental periods can lead to changes in the structure and function of the nervous system. This phenomenon, known as neuroplasticity, can result in long-lasting alterations in pain processing pathways.

What strategies can be employed to mitigate the long-term impacts of infant pain? Implementing comprehensive pain management protocols, minimizing unnecessary painful procedures, and providing appropriate pain relief during necessary interventions are key strategies. Additionally, promoting a nurturing and supportive environment can help buffer the stress associated with painful experiences.

The Role of Early Intervention

Early and effective pain management in infancy is crucial for several reasons:

  1. It prevents immediate suffering and distress
  2. It supports optimal growth and development
  3. It helps establish healthy pain coping mechanisms
  4. It may reduce the risk of future pain-related issues
  5. It promotes trust between the infant and caregivers

By prioritizing pain management from the earliest stages of life, healthcare providers and parents can contribute to better long-term outcomes for infants, both in terms of their physical health and emotional well-being.

Innovative Approaches in Infant Pain Management: Emerging Technologies and Techniques

As our understanding of infant pain continues to evolve, so do the methods and technologies used to manage it. Researchers and healthcare providers are constantly exploring new approaches to enhance pain relief and comfort for the youngest patients.

Technological Advancements

  • Non-invasive pain monitoring devices
  • Virtual reality distraction techniques adapted for infants
  • Smart pacifiers with built-in pain-relieving features
  • Advanced topical anesthetic delivery systems

Novel Pharmacological Approaches

  • Targeted pain medications with fewer side effects
  • Personalized dosing based on genetic factors
  • Nanotechnology-based drug delivery systems

Integrative Medicine Techniques

  • Adapted acupressure methods for infants
  • Gentle infant massage protocols
  • Age-appropriate mindfulness and relaxation techniques

How are these innovative approaches being integrated into clinical practice? Many of these techniques are still in the research and development phase, with some undergoing clinical trials. Healthcare facilities are gradually incorporating proven innovations into their pain management protocols, often starting with pilot programs before wider implementation.

What challenges exist in developing new pain management techniques for infants? The unique physiology of infants, ethical considerations in pediatric research, and the need for long-term safety data all present challenges in developing and validating new pain management approaches. However, interdisciplinary collaboration and advances in technology continue to drive progress in this critical field.

As we look to the future of infant pain management, it’s clear that a combination of innovative technologies, refined pharmacological approaches, and holistic care strategies will play a crucial role in enhancing the comfort and well-being of our youngest patients. By staying at the forefront of these advancements, healthcare providers can continue to improve outcomes and quality of life for infants experiencing pain.

Pain in Infants (Babies)

Article Translations: (Spanish) (Hmong) (Somali)

Our commitment to pain management

We believe infants have a right to the best level of pain relief that can be safely provided. The Children’s Comfort Promise™ states we will do everything possible to prevent and treat pain, so we take a team approach to pain and anxiety management, using medicine and non-medicine therapies. Our goal is to have staff and families work together to assess pain promptly and treat it effectively.

Do infants have pain?

Even though infants are still developing and cannot tell us about their pain, they do feel pain, and their pain can be treated. The health care team will do all they can to relieve pain and make your baby comfortable.

Why do infants have pain?

Pain can have many causes, including:

  • soreness after surgery caused by:
    • the incision (an opening made in surgery)
    • stretching or swelling of tissue or organs
  • procedures such as starting an IV or drawing blood for a lab test
  • nerves that sense tissue damage or swelling
  • an achy feeling that can be caused by an infection
  • sore muscles from being in bed for a long time
  • discomfort from tubes
  • skin abrasions or sores

How do we know an infant is in pain?

Infants cannot tell us about their pain in words, like older children, but they do give us clues by certain behaviors. We can measure pain by observing things like sleep, irritability, restlessness, appetite, movement, and vital signs (heart rate, breathing rate, blood pressure) to help decide if your baby is having pain.

How do infants act when in pain?

Infants will act differently when they are in pain than when they are comfortable. Each infant will respond individually and may be inconsistent in how they react from time to time. Infants use a combination of behaviors to signal pain. These signs may occur when the infant is not in pain, but combinations are usually present in an infant with pain. Look for the clues listed below. 

  • Crying: Your baby may cry robustly. Crying is often increased in pitch and length of time. Babies who are very sick or premature and have less energy may be silent even though they are uncomfortable.
  • Facial expression: Babies may have a furrowed or deeply wrinkled brow with eyes squeezed shut. Sometimes their chin quivers. Even babies on breathing machines may do this.
  • Muscle tension: Babies will tense up their muscles, pulling the arms in and the legs up or sometimes stretching everything out (this is called flailing). They may also clench their fists or keep their body rigid. Babies who are very sick may lose muscle tension and become floppy.
  • Babies in pain are also often irritable, restless, may refuse to eat and might be unable to sleep.
  • Movement will depend on your baby’s health status and energy level. Some babies will squirm and vigorously bend arms and legs. Babies that are frail may be very quiet and not move.
  • Sleep/wake patterns: Babies in pain are often fussier and sleep less. Some babies may withdraw and seem to be asleep all the time.

What can parents do?

Parents have a very important role. Because you know your baby best, you can work closely with Children’s staff (such as doctors, nurses, or child life specialists) to make decisions about managing pain. You are the best person to help your baby deal with new or difficult situations. To help your baby cope with pain, you can:

  • Be present, or ask others who know your baby to visit.
  • Tell the staff if you think the pain is not being controlled, or if your baby is ready to have pain medicine decreased because he or she is too sleepy or more active.

Use routine calming activities before and after a stressful event: gently patting or massaging your baby, holding, rocking, or talking in a soothing voice.

What can be done to reduce pain?

Non-medicine methods

Pain is both a physical and emotional state. Infants feel pain in their body, and they may also have thoughts and memories about pain. Because infants do not yet have language, it is hard for us to know exactly what they think of it. We will partner with you to try  and reduce both the feelings and the worry about pain. Here are some things that can help reduce pain for your baby:

  • Change the infant’s environment. Less light, noise, and activity at the bedside will often help calm your baby.
  • Sucking on a pacifier can help an infant cope with procedures and other painful events.
  • Sugar water (24 % sucrose) is often used before, during, and after needle and other procedures to help with pain. (See the education sheet for Sucrose 24%)
  • Distractions like using a soothing voice, music, stories, or songs can take an infant’s attention away from the pain or the procedure.
  • Holding your baby; rhythmic motion, rocking or other slow, steady movement can help.
  • Positioning infants so that they are more contained and warmer can be very comforting.
  • Doing Kangaroo Care or skin-to-skin contact can be very soothing and relieve pain.
  • Rubbing or gentle massage helps relax the muscles and the nerves that send pain messages to the brain, so the brain does not sense as much pain.

We will help you to learn how to use any or all of these techniques with your baby. Please check with your child’s nurse or provider to learn more.

Medicines 

There are many types of pain medicines we can use. Which type is best for your baby will depend on many things, including the type of pain, how long it will last, and the reason your child has pain. Some medicines are described below.

Numbing cream, such as 4% lidocaine, can be put on the skin to numb it before a needle procedure such as an IV start, lab draw, or injection. It has to be on for at least 30 minutes to work best and help reduce discomfort with needles. It is not usually used on babies less than 37 weeks of gestation. (See the education sheet, ” Anesthetic (Numbing) cream.”)

Non-steroidal anti-inflammatory drugs (NSAIDs) reduce pain and inflammation. They can be bought over the counter and help manage mild to moderate pain. To reduce stomachache, they should be taken with food or formula when possible. Ibuprofen (Pediaprofen®, Motrin®, Advil®, or another brand) is an example of an NSAID.

Acetaminophen (Tylenol® or another brand) is another over-the-counter medicine that helps treat mild to moderate pain. It has fewer side effects than NSAIDs but does not reduce inflammation.

Opioids are strong medicines used to treat moderate to severe pain, often used after surgery. They may be given by IV or taken by mouth. Opioids can have side effects of itching, nausea, and constipation. Infants will often become sleepy and their breathing can slow down. Sometimes NSAIDs or acetaminophen and opioids are used together. To prevent constipation, your baby may need more fluids than usual, or a stool softener.

After your baby goes home, follow your doctor’ instructions about giving pain medicines. Give the medicine as soon as the pain starts. Severe pain is harder to take away. Be sure to give medicine at bedtime to help your baby sleep comfortably. Some medicines need to be given around the clock. Your doctor will tell you the schedule for this if it is needed.

Be sure to call the doctor if the medicine does not seem to help the pain, or if the pain becomes worse. If you call the doctor about pain you might be asked if your baby has a fever, how severe the pain is based on how your baby is acting, and what the wound or surgical site looks like (if there is one).

Questions?

This sheet is not specific to your child but provides general information. If you have any questions or concerns, please talk to the doctor or the staff working with your child. Your doctor or nurse can also access other pain experts in the hospital. Good pain management is a team effort.

Last Reviewed 6/2020

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Pain management in babies | Pregnancy Birth and Baby

Pain management in babies | Pregnancy Birth and Baby

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If you have given your child too much ibuprofen or paracetamol, call the Poisons Information Centre (13 11 26) immediately or take them to your nearest hospital emergency department.

Key Facts

  • Your baby can’t tell you when they are in pain, so it’s a good idea be aware of the signs.
  • In the first year of life, your baby will have vaccinations and may undergo procedures like blood tests that cause minor pain and distress, but they are very important since they help keep your baby well.
  • There are many ways to help reduce your baby’s pain including talking or singing to your baby, breastfeeding, swaddling and taking your baby to a dark, quiet room.
  • Medicines like paracetamol and ibuprofen can be used for temporary relief of pain and discomfort.
  • Any baby or young child who is unwell or in moderate to severe pain should see a doctor to find the source of the pain.

How do I know if my baby is in pain?

It can be difficult to know if a baby is in pain since they can’t directly communicate how they are feeling, but there are signs that can help you recognise when they are in pain. For example, if a baby is in pain:

  • they may cry or whimper and be unable to settle
  • they may be tense, with clenched fists and may keep their arms and legs close to their chest
  • they may be fidgety, agitated or have an disturbed wake / sleep schedule
  • they may be pale, flushed or sweaty
  • they may shut their eyes tightly, furrowing their eyebrows or have larger than normal pupils

As a parent, you know your child best — if you notice your baby sounds, looks or behaves in an unusual way and you are worried they may be in pain, seek medical advice.

A doctor or baby health clinic can check for other signs that your baby might be unwell, such as an unusual heart rate or blood pressure.

Pain during procedures

In the first year of life, your baby will undergo several medical procedures. These cause minor pain and distress, but they are very important since they help keep your baby well.

In the first 3 days of your newborn’s life, a small amount of blood will be taken from their heel. This newborn screening test (or ‘heel prick test’) is done to check for rare but serious conditions. You will also be offered a number of vaccinations, which help prevent some serious contagious diseases.

If your baby is born prematurely, or with a medical problem, they may also require blood tests, feeding tubes, intravenous (IV) lines, surgery or other medical procedures. While these procedures may cause your child some pain in the short-term, the aim is to ensure their long-term health and wellbeing.

How can I help my baby in pain?

You are one of the greatest sources of comfort to your baby, and just being close to them may have a calming effect.

Some good pain reducing techniques include:

  • talking or singing to your baby
  • taking your baby to a dark, quiet space
  • swaddling your baby
  • breastfeeding or offering your baby a dummy
  • nappy changing

Other pain reducing techniques involve touching or holding your baby in a certain way. Useful techniques include:

  • tactile soothing (stroking your baby’s head and back softly)
  • ‘kangaroo care’ (skin-to-skin contact between you and your child, where you are both covered by a blanket)
  • holding your baby with both hands (to provide a feeling of security)
  • letting your baby hold your finger

If your newborn undergoes a painful procedure, their doctor or nurse may suggest you breastfeed or hold your baby skin-to-skin if possible, or give them a sugar (sucrose) solution. These techniques are proven to have a calming and pain relieving effect on infants.

Video provided by Sharing Knowledge About Immunisation (SKAI)

When can I give my child medicine for pain-relief?

You can give your child medicines such as paracetamol and ibuprofen for short-term relief of symptoms such as pain or fever. While they won’t make the cause of the pain go away, they will make your baby feel and sleep better

  • Paracetamol may be given from 1 month of age, every 4 to 6 hours in the correct dosage (based on age and weight), but no more than 4 times in 24 hours.
  • Ibuprofen may be given from 3 months of age, every 6 to 8 hours in the correct dosage (based on age and weight), but no more than 3 times in 24 hours. If your child has a bleeding disorder, do not give them ibuprofen.
  • Never give your child aspirin, unless specifically instructed by your doctor.

It’s important to make sure that you give your child the correct dose of pain medicines for the shortest period possible. Read the instructions on the pack carefully, as the amount your baby needs will be specific to your baby’s age and weight, and the strength of the formulation you buy. Giving your child too much medicine or giving it too frequently could be harmful.

Where can I get help?

Any baby or young child who is unwell or in moderate to severe pain should see a doctor to determine the source of the pain.

Do not give your baby or child paracetamol or ibuprofen for more than 48 hours without seeing a doctor.

Ask your pharmacist if you are unsure of the correct dose of medicine for your baby.

Speak to a maternal child health nurse

Call Pregnancy, Birth and Baby to speak to a maternal child health nurse on 1800 882 436 or video call. Available 7am to midnight (AET), 7 days a week.

Sources:

Royal Children\u2019s Hospital
(Neonatal Pain Assessment),
Government of South Australia
(Post-natal care),
Miracle Babies foundation
(Miracle Babies foundation),
Royal Children\u2019s Hospital
(Sucrose (oral) for procedural pain management in infants),
Royal Children’s Hospital Melbourne
(Pain relief for children – paracetamol and ibuprofen)

Learn more here about the development and quality assurance of healthdirect content.

Last reviewed: November 2022

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Related pages

  • Helping kids with medical procedures and hospital stays
  • Breastfeeding your baby
  • Immunisation and vaccinations for your child
  • What is kangaroo care?

Need more information?

Pain management (acute) – children – Better Health Channel

If you think your child is in pain, always see your doctor for diagnosis and treatment.