Is the Baby in Pain? Brain Scans Can Tell

By Moheb Costandi

Pain in infants is heartbreaking for new parents, and extremely difficult to treat effectively—if at all. Every year an estimated 15 million babies are born prematurely, most of whom will then undergo numerous lifesaving but painful procedures, such as heel pricking or insertion of a thin tube known as a cannula to deliver fluids or medicine. Preterm babies in the intensive care unit are subjected to an average of 11 such “skin-breaking” procedures per day, but analgesia is only used just over one third of the time.

We know that repetitive, painful procedures in early infancy can impact brain development negatively—so why is pain in infants so undertreated? One reason is the lack of standard guidelines for administering the drugs. Some analgesics given to adults are unsuitable for infants, and those that can be used often have different effects in children, making dosing a problem.

What is more, newborn babies are incapable of telling us how they feel, making it impossible to determine how effective any painkiller might be. Researchers at the University of Oxford may now have overcome this latter challenge, however. They report May 3 in Science Translational Medicine having identified a pain-related brain wave signal that responds to analgesics, and could be used to measure the drugs’ efficacy.

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