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Premature babies probably feel and are aware of pain

Although it is wellknown that premature babies react to pain, it has not been known to what extent they are aware of pain and uncomfortable procedures. Therefore premature infants have not always received sufficient analgesia.

Now, however, the grounds for this have been seriously undermined by a new doctoral thesis from Karolinska Institutet (KI) in Sweden. New measurement techniques show that even premature babies display all the signs of a conscious experience of pain.

For many years, doctors have assumed that foetuses, premature babies and fully developed new-born babies do not have the cerebral cortical functions required to feel pain. Babies’ reactions to potentially painful stimuli have been explained away as unconscious reflexes, and so doctors have felt it justified to withhold painkillers during surgery and the like so as to avoid adverse reactions.

The doctoral thesis by Italian-Swedish researcher Marco Bartocci now shows that the brains of premature babies are far more developed than previously thought. His studies using infrared spectroscopy, carried out at the Astrid Lindgren Children’s Hospital in Stockholm, Sweden, show that pain signals from a pin prick are processed in the cerebral cortex of premature babies in the same way as in adults. This means that all known pre-conditions for the conscience experience of pain are present, even though this still does not provide any conclusive evidence that they actually undergo a subjective painful experience.

The results of the processing of painful stimuli have been published in the scientific journal Pain and have been cited in a news article in Nature. They are expected to have a major impact on pain-relief management for new-born babies as well as on approaches to child development in general. Public defence of doctoral thesis will be held on December 8. Professor Michael Wweindling from the University of Liverpool, UK is the external examiner.

Thesis: Brain functional near infrared spectroscopy in human infants: cerebral cortical haemodynamics coupled to neuronal activation in response to sensory stimulation , Department of Women and Child Health, KI.

Katarina Sternudd | alfa
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