Pain in babies is extremely heartbreaking for parents, and can very difficult to treat effectively.
Every year an estimated 15 million babies are born prematurely, most of whom will then undergo a number of painful and lifesaving procedures, such as heel pricking.
Premature babies in the ICU are subjected to an average of 11 such “skin-breaking” procedures per day - but painkillers are only used in just one third of them.
It has been said countless times that repetitive, painful procedures in infancy can have a negative impact on brain development.
There is a lack of standard guidelines for administering the medication to newborns, and some painkillers given to adults are not suitable for infants, and those that can be used often have different effects in babies.
Also, newborn babies cannot communicate with us, making it hard to know how effective painkillers are.
Researchers at the University of Oxford now have overcome this latter challenge having identified a pain-related brain wave signal that responds to painkillers, and could be used to measure the medication’s efficacy in babies.
The study, which was published in Science Translational Medicine, used electroencephalography (EEG) to record the brain wave patterns of 18 healthy, full-term newborns who were exposed to painful and painless stimuli.
The scientists performed the heel prick procedure on the babies, which is used routinely to obtain blood samples in babies, and applied low-intensity forces to the surfaces of their little feet.
The research found the painful and painless procedures produced different brain-wave patterns. "Both of the painful procedures, but not the other stimuli, elicited an identically large response, detectable by an electrode placed at the top of the head approximately half a second later."
Rebeccah Slater, a lead author on the report, explained the findings: “We can now objectively measure pain-related brain activity and determine whether different pain-relieving drugs effectively reduce pain during essential medical procedures.”
“We can also see how other interventions such as gently stroking the baby changes pain-related brain activity or whether different experiences such as a vaginal birth or C-section alters pain sensitivity in the newborn infant.”
Rebeccah mentioned that they did not develop the EEG measurements to assess pain in individual infants, but hopes they will be useful for others working with newborns in clinical trials and research investigations.
“We are now using these measures in the Procedural Pain in Premature Infants trial to test whether they can provide effective pain relief for prematurely born babies during invasive medical procedures. Morphine is frequently given to adults when they experience pain, but it is not clear whether it provides effective pain relief in babies.”
"We will test whether babies who are given morphine experience less pain, and whether reducing pain during a painful eye exam improves stability of the heartbeat and breathing after the procedure.”