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Study suggests need for better pain management in newborns

St. Louis, July 6, 1999 -- During nursing and medical procedures in the hospital, premature infants respond to pain and can tell the difference between more and less painful procedures. They also react more to pain as they grow older. Researchers at Washington University School of Medicine in St. Louis report these findings in the July issue of Pediatrics and recommend universal pain management in newborns to reduce the acute and long-term impact of early procedural pain.

"These findings underscore just how sophisticated newborns are," said Fran Lang Porter, Ph.D., assistant professor of pediatrics and the study's lead author. "The study shows that not managing their pain, as if their early experiences don't matter, is a real mistake. We're beginning to understand that what we're doing has long-term effects."

As part of their required clinical care in a hospital nursery, infants, whether healthy or sick, can be exposed to procedures that adults consider painful. In one of Porter's previous studies, physicians and nurses reported that babies receive very little pain relief and few comfort measures during required medical procedures in the hospital and elective procedures such as circumcision. The doctors and nurses in the study believed, however, that babies can feel as much pain as adults.

There is a close relationship between how adults behave in response to pain, how painful they sense the stimulus to be and how their bodies react to the stimulus, studies have shown. Porter decided to find out if the same relationship holds true for newborns by monitoring their responses to nursing and medical procedures during hospitalization. Finding that the babies didn't react to pain and that their caregivers didn't see a change in behavior might help explain why doctors and nurses seldom manage pain in newborns during painful procedures.

Specifically, Porter set out to determine if newborns respond more as proced
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Contact: Diane Duke Williams
duke@medicine.wustl.edu
314-286-0111
Washington University School of Medicine
7-Jul-1999


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