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We Can't Really Tell When Infants Are In Pain, But A New Technique Could Change That

According to the World Health Organization, about 15 million babies are born prematurely every year. Most must undergo months of invasive, painful procedures. But because babies can't talk, there's no way to know how much pain the little ones are really in. What if there was a way to measure—and thus manage—infant pain? Researchers at the University of Oxford may have found one.

Infants Feel Pain, Too

Assessing pain in infants is a long-standing issue. It was only in 1987 that the American Academy of Pediatrics declared it unethical to perform surgery on infants without anesthetics—a practice sometimes followed based on a misguided belief that very young babies can't feel pain. To determine whether a baby is in pain, doctors and nurses usually use behavioral and physiological signs, like facial expressions and heart rate. More recently, advanced techniques such as electroencephalogram (EEG) and fMRI have helped medical professionals tell when an infant is in pain, but they still can't tell how much pain it's in—and, therefore, how well pain relief is working. But the new technique out of the University of Oxford may change all that.

By placing electrodes from an EEG on babies' scalps and giving their heels a mild poke, the researchers managed to record pain signals in the 72 infants they tested. They then compared that data to a "template of pain-related brain activity" to determine the degree of pain the infants were in. Significantly, the researchers found that the pain signature recorded by the EEG was not seen after bright lights, loud noises, or when the babies' feet were anesthetized, but only after the painful poke. Their research was published in May 2017 in the journal Science Translational Medicine.

A New Frontier for Infant Care

The device isn't ready for the limelight—yet. The study showed the device was accurate only about 68 percent of the time, The Scientist notes, and researchers hope to conduct further research before the device is used clinically. But many researchers are already excited about the possibilities. Ruth Grunau, a neonatology researcher at the University of British Columbia in Canada, told Inside Science that "this work is extremely important to start quantifying analgesic response and hopefully understanding the pain state of the baby through brain measures." She noted that pain in babies born prematurely is associated with a number of negative effects, including altered brain function, lower IQ, and behavioral problems. Other studies have found that pain can result in harm to the immune system or even developmental delays.

So far, the biggest barrier to easing infant pain has been our limited understanding of it. By shedding light on infant pain, the Oxford University team may just pave the way to help us manage it, which could have crucial long-term benefits.

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Written by Stephanie Bucklin May 24, 2017

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