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Pain management critical in babies (8-30-99)

"Shawn" was born prematurely. As he undergoes numerous medical procedures, his doctors and nurses never forget he feels pain. They are sensitive to his tiny body's reactions to everything they do, whether it's painful, like an injection, or bothersome, like attaching monitor leads with adhesive.

Today's health professionals are more attentive to the discomfort that can accompany pediatric care than ever before.

"It's not that physicians and nurses don't believe babies feel pain. The questions are, 'How severe is the pain?' 'How risky is the pain relief?' 'How is the baby affected by the pain?' Also, since babies' brains are not fully developed, the fact that they do not remember pain has had an impact on the approach to pain management," says Marilyn Escobedo, M.D., division chief of neonatology at The University of Texas Health Science Center at San Antonio. "However, our ability to monitor and support babies who are gravely ill has made the use of powerful pain relief much less risky than it used to be."

Both premature and full-term babies experience pain. The size or weight of an infant does not matter; each responds similarly when undergoing medical procedures.

"Babies cannot tell us if something hurts. Through keen observation, we look for signs that a baby is hurting, such as increases in heartbeat and respiratory rate. The signs are ever so subtle, especially with premies," says Dr. Escobedo.

"It's not something physicians or nurses can learn from a book. It requires actual hands-on experience with babies from all age groups. After a period of time, the physician or nurse can begin to tell when something's wrong with the baby because of the way the baby is acting."

Advances in technology have been a tremendous help in keeping better tabs on pain management in babies, she adds. "Premature and full-term babies today have available to them medical care that wasn't available a few years ago, and that's because we, as medical professionals, continue to learn and our machinery becomes more and more sophisticated," says Dr. Escobedo.

Meanwhile Shawn, who was born more than three months early, is fighting for his life and faces countless medical procedures. He has a chance of survival, however, and any pain he might face will always be addressed compassionately by medical professionals.

Contact: Myong Covert