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Pain in the Unborn and
Newborn Child: Part Two Part Three of Three Yesterday I began discussing the issue of whether or not babies can feel pain the way adults do. I had my first experience with that question 40 years ago. I had to hold my newborn baby while he had routine blood work done. Forty years ago we were told that babies couldn't really feel pain the way adults do.
Today, we know differently. For example, research on babies, born with diabetes, has shown us that babies learn from the experience. These babies have to have blood drawn one hour after birth and every 2 to 4 hours afterward for the first day after birth. Over the course of the day, the babies begin to anticipate the painful "stick" before it comes, when the staff starts to prepare the heel with an alcohol swab. They start to cry and show defensive movements. Furthermore, we have learned that the stress responses that accompany pain have a tendency to reduce the healing and recovery in the babies after surgeries. When the babies receive medication to control their experience of the pain, their recovery is faster and more complete. Doctors use such medications today when performing circumcisions, although they didn't do so previously. Research on babies, who have been circumcised without pain-inhibiting medication, also produced interesting results. These babies tended to become especially sensitive to pain and showed greater distress later on when they were exposed to lower levels of pain. In other words, they appeared to learn that any pain leads to having a pain response. If they had high levels of response as newborns, then they responded in this way for any subsequent pain experiences. These babies actually became hyper-sensitive cry-babies as a result of their early experience with pain. But, do babies feel pain in the same way as adults. Interestingly, we are learning that they may actually feel much greater pain than adults feel. In order to feel pain, it is necessary to have pain receptors. These nervous system receptors begin to form at 5 weeks after conception in the womb and appear throughout the body by 18 weeks. These pain receptors continue to develop, so that between weeks 20 and 30 in the womb, an unborn child has more pain receptors per square inch than at any other time, before or after birth. The reduction in these pain receptors occurs slowly, so that newborn babies actually feel more pain at this time of their lives than at any later time. They feel more pain than adults. Furthermore, our bodies have wonderful mechanisms that inhibit pain, once it starts. These include chemicals that act on the wound itself and neuro-chemical blockers that limit the spread of the pain sensations throughout the nervous system. Mechanisms that inhibit or moderate the experience of pain do not begin to develop until weeks 30-32 in the womb. These mechanisms are not fully developed until well after birth. Not only do newborn babies feel the pain more, they also inhibit it less well. In addition, adults use cognitive processes to help them cope with the pain. For example, adults distract themselves from the pain by analyzing the causes of the pain, the reasons an accident happened, what one can do to prevent it in the future, etc. Babies don't yet have these kinds of cognitive defense mechanisms to help them deal with pain. In addition, adults have the advantage of years of experience with pain, so they know that it will pass quickly if they don't focus on it too much. All of the research teaches me that my baby boy was exposed to a lot of needless pain 40 years ago, before we knew how much these babies could really feel and what the effects would be on them. |
