Infants exposed to repeated painful stimuli, such as heel sticks, in the first 24 to 36 hours of life exhibit more intense pain responses during subsequent venipuncture, according to results of a prospective cohort trial reported in the Aug. 21 issue of The Journal of the American Medical Association.
To avoid the development of anticipatory pain and hyperalgesia, the investigators recommend closer attention to pain management for neonates. “This was the first study to look at anticipatory pain responses in newborns,” lead author Anna Taddio, PhD, from The Hospital for Sick Children in Toronto, Ontario, Canada, says in a news release. “This research confirmed anecdotal reports that infants become hypersensitive to pain and learn to anticipate pain as a result of cumulative exposures to pain.”
This study used double-blinded raters to compare 21 full-term newborns born to diabetic mothers with 21 newborns whose mothers had uncomplicated pregnancies. Only infants born to diabetic mothers had repeated heel lances during the first 24 to 36 hours of life to monitor blood glucose, averaging 10 heel lances per infant. All subjects were healthy and on the postnatal ward with their mothers, and the groups were well-matched for birth characteristics including weight, gestational age, sex, and type of delivery.
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