For these infants, analgesic agents were provided in only 6.8% of all procedures ( Johnston, Collinge, Henderson, & Anand, 1997). Premature infants in Canadian neonatal intensive care units (NICUs) were subjected to an average of two and up to eight painful procedures per day. Indeed, a longitudinal study showed that the youngest preterm neonates undergo an average of 750 procedures during their hospital stay ( Porter, Wolf, & Miller, 1999).
Premature human infants and sick newborns, given their typical experiences, are subjected to multiple procedures including heel lancing, intravenous catheter insertion, chest tube insertion, endotracheal tube suctioning, and surgery. This is true for all infants and is especially true when caring for preterm human infants or sick newborns. The goal is to provide the healthiest outcome for infants thus, health-care professionals, including perinatal nurses, need to develop a model of infant pain outcomes based on the best evidence. Recent physiologic studies increase the urgency for professionals to replace this old model of infant pain with one that recognizes its potential for negative and long-term impacts.
If the patient never returns to complain about the pain later, how could it be very important? Now, as the knowledge base about infant development and human physiology is rapidly growing, serious flaws in old assumptions emerge to challenge long-held beliefs about pain in infants. Superficial observations conceded that pain medications had some risks along with their advantages, and that infants seemed to forget pain anyway. This was not because anyone wanted to hurt babies.
For years, health-care practitioners in the United States have cared for infants without viewing pain as one of the significant risks or disadvantages in making treatment decisions.
This is especially true of newborn infants, either full or preterm. Pain is difficult to assess and even more challenging when its victims are very young or preverbal.