Touch Best for Newborn Pain Management?
It is touch, and not drugs, that help newborns manage pain better. The fact is reiterated by the American Academy of Pediatrics (AAP) in its updated policy for prevention and pain management in babies.
"When we have to use medications, we should be very thoughtful and be very mindful of the risks and benefits of using each different kind of drug," said lead author Erin L. Keels via the AAP Publications. The experts noted that there are 40 different tools from which health workers and neonatal caregivers can assess the baby's condition.
"The cues from baby to baby are just a little bit different, and we're still trying to figure that out, how best to be able to evaluate each baby's level of pain individually," Keel said.
Medpage Today reported that several studies have already established that "nonpharmacological therapies" draw better results when it comes to pain management in babies. These techniques include skin to skin contact, stimulation of the senses (visual, auditory, gustative or tactile) and even breastfeeding.
In fact, a study published in the National Institutes of Health cited that, with babies undergoing venipuncture or heel lance procedure, breastfeeding -- which comprises a rocking motion while carefully positioning the baby against the mother holding her -- can bring relief and calm. The infant is able to hold her pain down better as she's getting the necessary medical tests.
Another study published in the National Institutes of Health showed the effects of sensorial stimulation versus treatments like oral sugar (sucrose). While sweet solution stimulants helped, the researchers observed that babies undergoing blood tests and other minor procedures were more responsive and cooperative when stimulated using soft speaking voices and infant massages.
Meanwhile, "pharmacologic interventions," which covers use of pain relievers, medication and sucrose and glucose, should be given to babies only after properly weighing and considering the risks and benefits. This includes how safe the medication is as some babies have experienced increased respiratory depression and hypotension with no actual help or relief from the drugs.
Keel acknowledged that the updated guidelines can be a big challenge for those caring for newborns. However, with different tools to use and combine, it would be best to push the objective so that babies can learn to cope without drug relief first.
"It is unlikely that a single, comprehensive pain assessment tool will be satisfactory for assessing neonatal pain for all situations and in infants of all gestational ages," Keel said in the AAP statement.