As recently as 30 years ago, it was thought that a premature baby’s nervous system may not be developed enough to process pain. While it is now widely accepted that premature babies do feel pain, essential medical procedures such as intubation, injections and blood tests, are still often performed without adequate pain relief. The average baby in neonatal care has around 10 medical procedures every day and those born extremely prematurely can have up to 50 procedures.
Pain in early life can have long-term consequences such as reduced growth, altered brain development [1] and reduced school-age academic performance [2]. Seeing their child in pain can also be incredibly stressful and upsetting for parents.
The research team is seeking to improve both the way that pain is treated in premature babies and how best to accurately measure it. The project aims to measure the effects of essential but painful procedures on breathing, heart rate, oxygen saturation, facial expression and brain activity in order to identify the best age-appropriate ways to assess and treat pain in premature babies. The researchers will also seek to find out whether a parent’s touch during a procedure can reduce pain in infants.
We are absolutely thrilled to announce that our first funding grant is going towards this pioneering research project. Many people do not realise just how many medical procedures a premature baby goes through during their hospital stay - and just how new the area of pain measurement and reduction is in neonatal research.
Anything that can be done to reduce a baby’s experience of pain and ensure the best possible long-term outcomes is a huge step in the right direction to ensuring that babies born prematurely receive the best possible standard of care. We are proud to support the vital work of the research team at the University of Oxford and look forward to continuing to build our partnership.
- Caroline Lee-Davey, Chief Executive at Bliss
Rebeccah Slater, Professor of Paediatric Neuroscience at University of Oxford said: "I am thrilled to be working with Bliss on this exciting research project. The Bliss research funding provides a tremendous opportunity to improve the measurement and treatment of pain in premature infants. Working directly with the doctors, nurses and parents on the neonatal unit gives us great insight into the challenge of providing effective and safe pain relief for prematurely-born infants."
In order to measure pain effectively, a specially designed EEG (electroencephalogram – a method of measuring the electrical activity of the brain) is used. The EEG will be placed on the infants whilst they have short medical procedures that are essential for clinical care – but unfortunately are also painful. These procedures include heel lances (to take blood samples), ROP screening (eye tests), cannulation and injections.
The researchers also plan to investigate whether parental touch can help alleviate pain during these procedures, by seeing what changes occur in brain activity of the infants.
Dr Vaneesha Monk, Clinical Research Director, said: “Parental involvement is absolutely key for our research – by working with parents we can make sure that our research is run in a family friendly way, and that our research explores areas that parents feel are important for their baby’s care and wellbeing.”
By researching and finding a reliable and accurate measure of pain in premature infants, the researchers will be able to enhance clinical care, and refine procedures to minimise pain in babies. With an accurate way to measure pain, new interventions – including medical and parental touch - will ensure that both short and long term improvements can be made to babies’ lives.
The research project will take place over a three year period, ending in 2021. Infants born between 24 and 37 weeks gestation will be recruited for the study from the neonatal unit at John Radcliffe Hospital, Oxford. Parents have, and will continue to be, consulted throughout the course of the research project in order to alleviate any fears and to ensure they understand the scope of the project and what the results could mean for babies in future.
[1] Susanne Brummelte PhD Ruth E. Grunau PhD Vann Chau MD Kenneth J. Poskitt MDCM Rollin Brant PhD Jillian Vinall BA Ayala Gover MD Anne R. Synnes MDCM Steven P. Miller MDCM Procedural pain and brain development in premature newborns Annuls Neurology 2012
[2] Hermann C, Hohmeister J, Demirakca S, Zohsel K, Flor H. Long-term alteration of pain sensitivity in school-aged children with early pain experiences. Pain 2006;125(3):278-285.
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