By Dianne I. Maroney
In the not so distant past, medical professionals believed infants were not able to feel pain due to their underdeveloped neurological systems. Recent research has proven that indeed babies do feel pain and in fact, premature infants may even be hypersensitive to pain and have a lower tolerance for pain. Because the very tasks done in the NICU to help preemies survive can also be painful, it's important to understand how to recognize when your preemie is in pain; and the best method of treating any pain or discomfort.
There are many different behaviors and physical responses one will see from a premature infant as she reacts to pain. Crying, difficulty sleeping, agitation, frowning, and clinching her fists are common preemie behavioral responses to pain. Physical responses include an increased heart rate, breathing faster, an elevated blood pressure, and/or a drop in her oxygen saturation. Although these are the most common reactions to pain, each preemie will behave differently using a variety of these responses. All preemies will feel and react to pain, even the tiniest and most frail.
There are many ways to help support a premature infant in pain. If the pain is mild, it helps to swaddle them gently, but tightly in a blanket. If a blanket can't be used, you can gently position her arms and legs tucked in front of her simulating the fetal position. When the pain is moderate to significant such as with needle sticks or after surgical procedures, pain medication should be used. Although most pain medications have not been tested and approved by the Federal Food and Drug Administration (FDA) there are medications that are commonly used in NICU's such as Fentanyl, Morphine, or even Tylenol.
It may be difficult for you, as a new parent to read your preemie's needs at first, but in time you will recognize if she is uncomfortable. Ask her nurse if your preemie is showing any signs of being in pain and what seems to work best to comfort her.
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