Until quite recently, many medical professionals and researchers thought that young infants’ brains were not developed enough to feel pain. The assumption was that newborn babies’ pain receptors are not fully formed and that any response they had to mild painful stimuli, like poking and prodding, were just muscular reactions.
New research has revealed that young babies feel pain even more intensely than adults.
However, this theory has been turned on its head by a group of Oxford Universty researchers recently. In their research using Magnetic Resonance Imaging (MRI) scans, they watched days-old babies’ brains light up in similar way to adult brains when exposed to mild pain.
The study
The study examined, with parental consent, 10 healthy infants aged between one and six days old and 10 healthy adults aged 23 to 36 years old. The babies, accompanied by their parents and research staff, were placed in a MRI scanner, where reports say they usually fell asleep.
MRI scans were run as the the babies were gently poked on the bottom of their feet with a special rod. Researchers describe the sensation of this as similar to being poked by a pencil — and mild enough that it didn’t wake the little ones. These MRI scans were then compared with scans of adults who were also poked in the foot, only four times harder.
With parental consent, babies in the study were placed within an MRI scanner and gently poked on the bottom of their feet with a special rod.
Image: YouTube screengrab
What happened next?
Eighteen of the 20 brain regions that were activated in the adults in response to the pain stimulus were active in the babies’ brains too. What this means is that babies not only feel pain in the same way that adults do, but they also have a much lower pain threshold.
Dr Rebeccah Slater of Oxford University’s Department of Paediatrics, and the lead author of the study says their research was particularly important when it comes to understanding how babies feel pain.
She explains, “Obviously babies can’t tell us about their experience of pain and it is difficult to infer pain from visual observations. In fact some people have argued that babies’ brains are not developed enough for them to really ‘feel’ pain, any reaction being just a reflex – our study provides the first really strong evidence that this is not the case.”
MRI scans give a comparison of brain activity in adults and babies when poked with a special retracting rod simulating a sensation of pain. Red-yellow coloured areas represent active brain regions. The side-on view on the far right shows the level at which each scan was taken.
Information and image from www.ox.ac.uk
What do the results of this study mean in relation to pain management in babies? Find out on the next page where you can also watch a video about the study.
What are the implications of this study?
Dr Slater explains that right up until the 1980s, it was quite common for babies to be given neuromuscular blocks but no pain relief medication during surgery. And as recently as 2014, a review of neonatal pain management practice in intensive care (in the UK) highlighted that although these babies underwent around 11 painful procedures a day, 60% of such babies did not get pain medication of any kind.
Having such experiences at such a young age may make these babies more sensitive to pain later in life, says Dr Slater, according to a Time report.
A study of circumcised baby boys, for example, found that those who received pain relief during the circumcision procedure felt less pain three months down the track when getting vaccinations, compared to those who didn’t receive any pain medication.
The latest Oxford University study on babies and pain proves that not only do our little ones experience pain just like adults do, but that they also seem to experience it more intensely.
This means that clinicians need to “think that if [they] would provide pain relief for an older child undergoing a procedure then [they] should look at giving pain relief to an infant undergoing a similar procedure” says Dr Slater.
For more about this study, watch this video below.
