Background:
Before the last few years, it was generally assumed that newborn babies did not feel pain, or if they did, that it was a rather vague and easily forgotten experience that did not need painkillers. Because of this, little analgesia (pain-relief) was used when newborns had operations (such as circumcision) or other medical procedures. The other reason analgesia was rarely used is because most strong painkillers can stop a baby from breathing unless carefully supervised. The belief that newborns felt little pain came from research that found that a newborn's pain sensing system was not yet fully developed, and that they had fewer pain-receptor cells and nerves than children and adults. Support for the theory also came from noticing that while newborns do cry after blood tests and other painful events, they can also cry in a very similar way from just being moved, or cry for no reason at all.
However it has become clear over the last decade that newborns do feel pain and that their crying from pain is different to "reflex" crying. It is also clear that very painful experiences are somehow remembered by babies. Research has recently shown that single, very painful experiences (such circumcision operations done without painkillers) result in the baby having exaggerated responses to later less painful experiences such as routine immunisations. This lasts for many months, and some suggest that it may last for years (although there is no evidence for this). Because of this new realisation about the importance of pain-relief for babies, newborns are now routinely given painkillers for most, if not all painful procedures (although not for immunisations).
One of the problems with giving newborns painkillers, is that many standard painkillers don't work well in newborns, partly because their nervous system is not fully developed. Because of this, there has been a lot of interest in "natural" pain-killing methods that might be more suited to the more primitive pain system of the newborn. For example, we know that certain tastes help reduce pain in newborns - and that as little as 2ml of milk or sugar can reduce pain in newborns (and also helps reduce "reflex" crying). When this was studied in newborn rats, it seemed that the milk and sugar stimulated the release of the body's natural painkillers, endorphins. Even just suckling and contact with the mother's skin helps to slightly to reduce pain levels, as babies who are held in full-body contact with their mother cry and grimace less when they have blood tests.
One question yet unanswered is whether breastfeeding itself might be an effective painkiller in newborns. Breastfeeding gives all of the natural methods of pain-relief, the full body contact, the suckling, and the milk and sugar. Plus breastmilk may contain natural pain-killing substances we don't know about. These researchers investigated whether breastfeeding babies during blood tests by heel-prick reduced the pain they felt.
Findings:
These authors studied 30 healthy full-term newborns that were breastfed and needed to have blood tests by heel-prick. With their mother's permission, the babies were randomly assigned to being breast-fed during the blood test, or wrapped in a blanket and laid in a bassinet during the blood test (which is the standard procedure). A researcher watched the baby throughout and after the blood test, and recorded how much and how long they cried, if their heart rate increased (a sign of pain) and how much they grimaced (facial contortions and grimacing is a recognised sign of pain in babies). The two groups were then compared to see if those which were breastfed had less pain.
Amazingly, the researchers found that crying and grimacing were reduced by 91% and 84% respectively if the baby was being breastfed during the blood test! Breastfed babies only cried of 4% of the time taken by the blood test, compared to the other babies who cried for almost half the whole procedure. In fact, three-quarters of the babies did not cry or grimace at all during the blood test. Also, the breastfed babies' heartrate did not increase almost at all during the test, again suggesting that breastfeeding acts to reduce pain significantly. The researcher concluded rightly that breastfeeding is actually a very potent painkiller - and is probably much more potent than most drugs!
Action Points:
------------------------------------------------------ कोई भी मूल्य एवं संस्कृति तब तक जीवित नहीं रह सकती जब तक वह आचरण में नहीं है.
Before the last few years, it was generally assumed that newborn babies did not feel pain, or if they did, that it was a rather vague and easily forgotten experience that did not need painkillers. Because of this, little analgesia (pain-relief) was used when newborns had operations (such as circumcision) or other medical procedures. The other reason analgesia was rarely used is because most strong painkillers can stop a baby from breathing unless carefully supervised. The belief that newborns felt little pain came from research that found that a newborn's pain sensing system was not yet fully developed, and that they had fewer pain-receptor cells and nerves than children and adults. Support for the theory also came from noticing that while newborns do cry after blood tests and other painful events, they can also cry in a very similar way from just being moved, or cry for no reason at all.
However it has become clear over the last decade that newborns do feel pain and that their crying from pain is different to "reflex" crying. It is also clear that very painful experiences are somehow remembered by babies. Research has recently shown that single, very painful experiences (such circumcision operations done without painkillers) result in the baby having exaggerated responses to later less painful experiences such as routine immunisations. This lasts for many months, and some suggest that it may last for years (although there is no evidence for this). Because of this new realisation about the importance of pain-relief for babies, newborns are now routinely given painkillers for most, if not all painful procedures (although not for immunisations).
One of the problems with giving newborns painkillers, is that many standard painkillers don't work well in newborns, partly because their nervous system is not fully developed. Because of this, there has been a lot of interest in "natural" pain-killing methods that might be more suited to the more primitive pain system of the newborn. For example, we know that certain tastes help reduce pain in newborns - and that as little as 2ml of milk or sugar can reduce pain in newborns (and also helps reduce "reflex" crying). When this was studied in newborn rats, it seemed that the milk and sugar stimulated the release of the body's natural painkillers, endorphins. Even just suckling and contact with the mother's skin helps to slightly to reduce pain levels, as babies who are held in full-body contact with their mother cry and grimace less when they have blood tests.
One question yet unanswered is whether breastfeeding itself might be an effective painkiller in newborns. Breastfeeding gives all of the natural methods of pain-relief, the full body contact, the suckling, and the milk and sugar. Plus breastmilk may contain natural pain-killing substances we don't know about. These researchers investigated whether breastfeeding babies during blood tests by heel-prick reduced the pain they felt.
Findings:
These authors studied 30 healthy full-term newborns that were breastfed and needed to have blood tests by heel-prick. With their mother's permission, the babies were randomly assigned to being breast-fed during the blood test, or wrapped in a blanket and laid in a bassinet during the blood test (which is the standard procedure). A researcher watched the baby throughout and after the blood test, and recorded how much and how long they cried, if their heart rate increased (a sign of pain) and how much they grimaced (facial contortions and grimacing is a recognised sign of pain in babies). The two groups were then compared to see if those which were breastfed had less pain.
Amazingly, the researchers found that crying and grimacing were reduced by 91% and 84% respectively if the baby was being breastfed during the blood test! Breastfed babies only cried of 4% of the time taken by the blood test, compared to the other babies who cried for almost half the whole procedure. In fact, three-quarters of the babies did not cry or grimace at all during the blood test. Also, the breastfed babies' heartrate did not increase almost at all during the test, again suggesting that breastfeeding acts to reduce pain significantly. The researcher concluded rightly that breastfeeding is actually a very potent painkiller - and is probably much more potent than most drugs!
Action Points:
- Breastfeeding your baby through blood tests, needles and other painful procedures will substantially reduce the pain and distress they feel. Insist on doing this even though the doctors and nurses may not like it.
------------------------------------------------------ कोई भी मूल्य एवं संस्कृति तब तक जीवित नहीं रह सकती जब तक वह आचरण में नहीं है.
