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A groundbreaking survey has revealed that a significant number of preterm babies, especially those born very early, are not receiving adequate pain management in neonatal care. The study, published in the journal Pain, is the largest of its kind to date, highlighting critical issues in the care of premature infants.
The research, conducted over 4.5 years, examined data collected from neonatal care staff who documented pain occurrences, causes, and treatments for premature babies in Sweden. It focused on 3,686 babies born between 22 and 31 weeks of gestation from 2020 to 2024. With a total observation period of over 185,000 days, the study sheds light on the prevalence and management of pain among the most vulnerable infants.
The study found that babies born extremely prematurely, at 22 to 23 weeks of gestation, experienced the highest rates of painful medical conditions and intense care procedures during their first month of life. These babies often require critical interventions like ventilator treatment, tube feeding, catheter insertions, and surgeries—all of which can be painful.
Mikael Norman, professor of pediatrics at Karolinska Institutet and the study’s lead researcher, emphasized the link between extreme prematurity and the need for intensive care, which often involves painful procedures. “There is a strong correlation between acute morbidity and being born very early. The earlier a baby is born, the more intensive care it needs, which involves procedures that can be painful,” he explained.
Despite the high proportion of babies undergoing painful procedures, the survey revealed that healthcare professionals reported only 45% of babies experiencing pain. This discrepancy suggests a possible underreporting or a failure to adequately recognize pain, rather than an effective prevention or treatment strategy. Surprisingly, the smallest and most premature infants, who were exposed to the most pain, had the lowest proportion of treatment with morphine, indicating potential undertreatment.
While the survey was able to document whether or not babies experienced pain on a given day, it did not assess the severity or duration of pain, which remains an area of concern. “Much is done to alleviate pain in babies, but health care professionals are not always able to determine whether children are in pain,” Norman noted. He called for better pain rating scales and improved physiological techniques to measure pain in these vulnerable patients.
Improving pain management for premature infants is critical, as research shows that unmanaged pain can negatively impact their brain development. Norman emphasized the importance of advancing pain relief techniques, including drugs that carry less risk of side effects.
“The vision for all neonatal care is to be pain-free,” he said. “The results of this survey will be crucial in improving neonatal care and guiding future research in the field.”
The findings call for an urgent need to refine the pain management protocols for premature infants, ensuring that their developmental needs are met in the most compassionate and effective ways.
Disclaimer: This article is based on a study published in Pain and aims to inform the public about the current issues surrounding pain management for preterm babies. It is important to note that the information presented reflects the findings of the study and does not imply universal applicability to all neonatal care settings. The approach to pain management may vary across institutions.
