Lessons from a Painful Past
For decades, doctors believed that babies didn't feel pain, based on flawed studies showing that sleeping infants didn't respond to light pinpricks. In fact, until the 1980s, many newborns who had heart surgery received no pain medication -- they were only given paralytic drugs that forced them to lie completely still, though fully aware, as their chests were opened.
These practices greatly disturbed Kanwaljeet Anand, MD, director of Arkansas Children's Hospital Research Institute Pain Neurobiology Laboratory, in Little Rock, who noticed babies had a rapid pulse and low blood pressure after cardiac surgery without pain control. "They appeared incredibly stressed," he recently told me. Two decades ago, Dr. Anand published a study showing that using proper anesthesia during infant heart surgery dramatically reduced deaths. His findings helped change how doctors think about neonatal pain, and today general anesthesia is standard for babies undergoing surgery.
More recent research has proven that even mild pain can have a major impact. Canadian doctors, for example, found that newborns who were circumcised without local anesthesia developed a form of post-traumatic stress disorder. Another study published in the Journal of the American Medical Association showed that newborns who received frequent blood tests would become upset as soon as they were swabbed with an alcohol wipe. And according to surveys of hospitalized kids of different ages, they reported that getting an IV caused some of their worst pain. "The science is increasingly clear that untreated pain can cause harm," says Gary A. Walco, PhD, professor of anesthesia at University of Washington School of Medicine, in Seattle. In articles for medical journals, he has argued that proper pain control for children is a basic human right. "In the overwhelming majority of cases, there is no need for kids to feel pain from medical procedures," he says.
Unfortunately, this message hasn't caught on widely enough yet. In 2006, a survey of newborn intensive care units found that doctors only checked for pain in 10 percent of newborns after major surgery, and many children received no pain medications to comfort them. Babies in intensive care had an average of 14 painful procedures per day.