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Prevention and treatment of neonatal pain

Kanwaljeet JS Anand, MBBS, DPhil, FAAP, FCCM, FRCPCH
Section Editor
Richard Martin, MD
Deputy Editor
Melanie S Kim, MD


Varying degrees of neonatal discomfort, stress, or pain may be associated with routine patient care and is associated with moderate to more severe invasive procedures. Care providers are expected to prevent any infant from experiencing pain.

This topic will address the prevention, control, and treatment of neonatal pain. The assessment of neonatal pain is discussed separately. (See "Assessment of neonatal pain".)


Advances in neonatal research demonstrate that newborns experience pain and that controlling pain has short- and long-term benefits for all newborns [1-3]. Professional bodies and parent groups expect health care providers to prevent infants from experiencing pain [4-6]. Varying degrees of neonatal discomfort or pain may occur during routine patient care (eg, gavage tube placement, bladder catheterization, or physical examination) [7], moderately invasive procedures (eg, suctioning, phlebotomy, or peripheral intravenous [IV] access), or more invasive procedures (eg, chest tube placement, circumcision, or central venous access). Pain is most common and intense in infants admitted to the neonatal intensive care unit (NICU). Infants admitted to the NICU frequently experience acute pain from skin-breaking procedures, established pain following surgery, and prolonged (chronic) pain from diseases like necrotizing enterocolitis (NEC) or epidermolysis bullosa. However, despite ongoing efforts, there remains no consistent definition for prolonged or chronic pain in newborn infants [8,9]. In part due to the lack of consensus regarding the definition of persistent neonatal pain, it appears that only 10 percent of neonates received daily assessments for prolonged continuous pain in the NICU [10]. (See "Assessment of neonatal pain".)


To ensure that neonates receive adequate pain control, a pain control program should be established for each health care facility that treats newborns and should include the following [4,11-13]:

Routinely assess the infant for detection of acute and/or prolonged pain. (See "Assessment of neonatal pain", section on 'Pain assessment'.)

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Literature review current through: Oct 2017. | This topic last updated: Apr 25, 2017.
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