About all

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 help alleviate their infant’s pain. What non-medicinal methods are effective for infant pain relief. Why is proper pain management crucial for babies.

Содержание

The Reality of Infant Pain: Debunking Misconceptions

For decades, a pervasive myth suggested that infants don’t feel pain or at least not to the same degree as adults. However, modern research has thoroughly debunked this notion. Infants do indeed experience pain, and their inability to verbalize it makes proper pain management even more crucial.

Why is this understanding so important? Unmanaged pain in infants can have long-lasting consequences, affecting their neurological development and potentially altering their pain responses later in life. This realization has led to a paradigm shift in neonatal and pediatric care, with healthcare providers now prioritizing pain assessment and management for even the youngest patients.

Common Causes of Infant Pain

Infants may experience pain due to various reasons, including:

  • Post-surgical discomfort
  • Medical procedures (e.g., blood draws, vaccinations)
  • Infections
  • Colic or digestive issues
  • Teething
  • Minor injuries or accidents

Understanding these potential sources of pain is the first step in providing effective relief and comfort to infants.

Decoding Baby’s Distress: Recognizing Pain Signals

One of the biggest challenges in managing infant pain is accurately identifying when a baby is in discomfort. Unlike adults or older children, infants can’t verbalize their pain or point to where it hurts. This communication barrier necessitates a keen understanding of non-verbal cues and behavioral changes that may indicate pain.

Behavioral Indicators of Infant Pain

Healthcare professionals and parents should be aware of the following signs that may suggest an infant is experiencing pain:

  1. Crying: Increased intensity, pitch, or duration of crying
  2. Facial expressions: Furrowed brow, squeezed eyes, quivering chin
  3. Body movements: Tensed muscles, pulled-in arms, raised legs, or rigid body
  4. Changes in sleep patterns: Difficulty falling asleep or staying asleep
  5. Appetite changes: Refusal to eat or decreased feeding
  6. Irritability and restlessness
  7. Changes in vital signs: Increased heart rate, breathing rate, or blood pressure

Is crying always an indicator of pain in infants? While crying is often associated with discomfort, it’s important to note that not all crying signifies pain. Babies cry for various reasons, including hunger, fatigue, or a need for attention. Conversely, some very sick or premature infants may be too weak to cry even when in pain. Therefore, it’s crucial to consider multiple factors when assessing infant pain.

The Parental Role in Infant Pain Management

Parents play a pivotal role in managing their infant’s pain. Their intimate knowledge of their baby’s normal behavior and temperament makes them invaluable partners in the pain assessment and management process. How can parents contribute effectively to their baby’s pain relief?

Strategies for Parental Involvement

  • Be present during medical procedures
  • Communicate observations about changes in the baby’s behavior to healthcare providers
  • Participate in pain assessment discussions with medical staff
  • Provide comfort through touch, holding, and soothing voices
  • Advocate for appropriate pain management when necessary

What specific actions can parents take to comfort their baby during painful experiences? Simple techniques like gentle patting, massaging, rocking, or talking in a soothing voice can significantly help calm an infant. These actions not only provide immediate comfort but also help strengthen the parent-child bond during stressful situations.

Non-Medicinal Approaches to Infant Pain Relief

While medication has its place in pain management, non-pharmacological methods can be highly effective in reducing infant discomfort. These approaches focus on creating a soothing environment and providing comforting stimuli to help babies cope with pain or distress.

Environmental Modifications

Creating a calm environment can significantly impact an infant’s comfort level. Consider the following adjustments:

  • Reducing ambient light levels
  • Minimizing noise and unnecessary activity around the baby
  • Maintaining a comfortable room temperature
  • Ensuring the baby is positioned comfortably

Comfort Measures

Several non-invasive techniques can help soothe infants and reduce their perception of pain:

  1. Sucrose solution: Administering a small amount of sugar water before, during, and after painful procedures can help reduce pain perception in infants.
  2. Non-nutritive sucking: Allowing the baby to suck on a pacifier can provide comfort during medical procedures.
  3. Swaddling: Wrapping the baby snugly in a blanket can provide a sense of security and warmth.
  4. Kangaroo care: Skin-to-skin contact between parent and baby has been shown to have numerous benefits, including pain reduction.
  5. Distraction techniques: Using soothing music, gentle singing, or storytelling can help divert the baby’s attention from pain or discomfort.

How effective are these non-medicinal approaches in managing infant pain? Research has shown that these methods can be highly effective, particularly for minor procedures or mild discomfort. In many cases, they can reduce or even eliminate the need for pharmacological interventions.

The Role of Healthcare Providers in Infant Pain Management

Healthcare providers play a crucial role in ensuring optimal pain management for infants. Their responsibilities extend beyond merely administering pain relief; they must also educate parents, assess pain accurately, and develop comprehensive pain management strategies.

Key Responsibilities of Healthcare Providers

  • Conducting thorough pain assessments using validated tools
  • Developing individualized pain management plans
  • Educating parents about pain recognition and management techniques
  • Monitoring the effectiveness of pain relief interventions
  • Advocating for evidence-based pain management protocols

What specific tools do healthcare providers use to assess infant pain? Several validated pain assessment scales have been developed for use with infants, including the FLACC (Face, Legs, Activity, Cry, Consolability) scale and the NIPS (Neonatal Infant Pain Scale). These tools help standardize pain assessment and ensure consistent care across different providers.

Pharmacological Approaches to Infant Pain Management

While non-medicinal methods are often the first line of defense against infant pain, there are situations where pharmacological interventions become necessary. Understanding the types of medications used, their indications, and potential side effects is crucial for both healthcare providers and parents.

Common Medications Used for Infant Pain Relief

  1. Acetaminophen (Paracetamol): Often used for mild to moderate pain and fever
  2. Ibuprofen: Used for pain and inflammation in infants over 6 months old
  3. Topical anesthetics: Applied to the skin before minor procedures
  4. Opioids: Reserved for severe pain, typically in hospital settings

How are dosages determined for infant pain medications? Medication dosages for infants are carefully calculated based on the baby’s weight, age, and overall health status. It’s crucial that parents never administer pain medications to infants without consulting a healthcare provider first.

Balancing Benefits and Risks

When considering pharmacological interventions for infant pain, healthcare providers must carefully weigh the potential benefits against possible risks. Factors to consider include:

  • The severity and duration of pain
  • The infant’s overall health status
  • Potential side effects of the medication
  • Interactions with other treatments the infant may be receiving

This balanced approach ensures that infants receive adequate pain relief while minimizing the risk of adverse effects.

Long-Term Implications of Infant Pain Management

The way pain is managed in infancy can have far-reaching consequences that extend well into adulthood. Recent research has shed light on the potential long-term effects of both undertreated pain and overzealous pain management in infants.

Consequences of Undertreated Pain

Failing to adequately manage infant pain can lead to several negative outcomes:

  • Altered pain thresholds later in life
  • Increased anxiety during future medical procedures
  • Potential developmental delays
  • Changes in stress response systems

Concerns About Overtreatment

While proper pain management is crucial, there are also concerns about potential overuse of pain medications in infants:

  • Risk of medication side effects
  • Potential for developing tolerance to pain medications
  • Concerns about long-term neurological effects of certain pain medications

How can healthcare providers strike the right balance in infant pain management? The key lies in individualized care plans that consider the specific needs of each infant, regular reassessment of pain levels, and a multimodal approach that combines pharmacological and non-pharmacological interventions as appropriate.

Emerging Trends and Future Directions in Infant Pain Management

The field of infant pain management is continuously evolving, with new research leading to improved understanding and novel approaches. Several exciting developments are shaping the future of how we address pain in our youngest patients.

Advancements in Pain Assessment Technology

Researchers are exploring innovative ways to objectively measure infant pain, including:

  • Brain imaging techniques to visualize pain responses
  • Wearable devices that monitor physiological indicators of pain
  • Artificial intelligence algorithms to analyze facial expressions and body movements

These technologies hold the promise of more accurate pain assessment, potentially leading to more targeted and effective pain management strategies.

Novel Non-Pharmacological Interventions

New non-medicinal approaches to infant pain relief are also being investigated:

  1. Virtual reality distraction techniques adapted for infants
  2. Music therapy protocols specifically designed for neonatal pain management
  3. Acupuncture and acupressure adapted for use in infants
  4. Mindfulness-based interventions for parents to help manage their own stress and better support their babies

How might these emerging trends change the landscape of infant pain management? As these new approaches are validated through rigorous research, they have the potential to provide healthcare providers with a broader array of tools to manage infant pain effectively. This could lead to more personalized pain management strategies that take into account individual differences in pain perception and response.

The Role of Genetics in Infant Pain Management

An exciting area of research is the exploration of genetic factors that influence pain perception and response to pain medications in infants. This field, known as pharmacogenomics, could potentially allow for highly personalized pain management strategies based on an infant’s genetic profile.

What are the potential implications of genetic testing for infant pain management? In the future, genetic testing might help predict which infants are more likely to experience severe pain or adverse reactions to certain medications. This information could guide healthcare providers in selecting the most appropriate pain management strategies for each individual infant.

Educating and Empowering Parents in Infant Pain Management

A crucial aspect of effective infant pain management is the education and empowerment of parents. When parents are well-informed about pain assessment and management techniques, they can play a more active role in their baby’s care, leading to better outcomes.

Key Areas of Parental Education

Healthcare providers should focus on educating parents in the following areas:

  • Recognizing signs of pain in their infant
  • Understanding the importance of pain management
  • Learning non-pharmacological comfort measures
  • Safe administration of prescribed pain medications
  • When to seek medical attention for pain-related concerns

Empowering Parents as Advocates

Beyond education, it’s important to empower parents to advocate for their infant’s pain management needs. This includes:

  1. Encouraging parents to communicate their observations and concerns to healthcare providers
  2. Involving parents in pain assessment and management decision-making processes
  3. Providing resources for parents to learn more about infant pain management
  4. Supporting parents in managing their own stress and emotions during their baby’s painful experiences

How can healthcare systems better support parent education and empowerment in infant pain management? Implementing comprehensive parent education programs, providing easily accessible resources (such as educational videos or online modules), and fostering open communication between parents and healthcare providers are all crucial steps. Additionally, support groups for parents of infants with chronic pain conditions can provide valuable peer support and information sharing.

By focusing on parent education and empowerment, healthcare providers can create a more collaborative approach to infant pain management, ultimately leading to better pain control and improved outcomes for infants and their families.

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

Back To Top

Pain management in babies | Pregnancy Birth and Baby

Pain management in babies | Pregnancy Birth and Baby

beginning of content

7-minute read

Listen

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

Back To Top

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.