More than four million babies are born in the United States every year. Of those, 13 percent will be born prematurely. For these infants, their time spent in the Neonatal Intensive Care Unit (NICU) is critical to the future of their well-being.

A recent study finds that routine tests performed on infants in the NICU can increase their pain response. It was once believed that newborns don’t feel pain from routine tests. However, some infants undergo many of these routine tests daily and this study shows that “repeated exposure to pain and stress early in life may have lasting effects, including increased pain sensitivity later in life,” according to Reuters.

Studies have shown that once a premature infant reaches school age, they have shown to be at significantly higher risk for attention deficit/hyperactivity disorder (ADHD), lower IQ, difficulties in social-emotional functioning and self-regulation and increased need for specialized school services.

There has been much study into NICU environments and how they can be improved to best suit the needs of the infant. Leading the way is Children’s Hospital Boston’s Director of Neurobehavioral Infant and Child Studies, Heidelise Als, PhD, whose work has focused for some time on pain how premature infants experience pain.
Als says the recent research is important because it points to frequent painful events whose side effects put the infant’s brain at risk. Pain can, for the most part, be prevented in these routine procedures by:

• using distraction techniques
• providing access to a mother’s milk or sugar water
• changing the infant’s position during the procedure
• encouraging parent involvement in the procedure
While some of these measures may seem like common sense, they are often not considered. Physicians underestimate how painful these routine tests can be and the consequences they can have on the baby.
Als’s NICU research takes a comprehensive approach. She looks at all of the events that can happen in a 24-hour period for an infant, including behavioral cues given by infants to see which events cause them stress. This sort of pain management leads to the overall well-being significantly better short-term and long-term outcomes for the infant.

Her approach has led to the education of NICU caregivers, including the parents of preemies. The care becomes collaborative with the infants. Skilled caregivers need to be emotionally in tune with the infant. Their connection allows the caregiver to read the world from the baby’s perspective.

Data shows that being able to read the language of the baby results in significantly better short-term and long-term outcomes. Als is the originator of the Newborn Individualized Development Care and Assessment Program (NIDCAP), which is an individualized, behaviorally-based developmental care model that’s changing NICUs around the world.

by Kristin Cantu with permission from