Helping Infants Suffering From Pain

(CBS)  This is part three of our special series, "Easing the Pain." CBS News contributor Sanjay Gupta reports that some doctors disagree over how to treat pain in infants - and sometimes, whether to treat it at all.

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In three short weeks of life, Josie Toland has undergone a lifetime's worth of medical procedures. She was born two months premature and developed serious lung problems, Gupta reports.

She's had tubes inserted to breathe and to eat, and constant sticks in her heels to draw blood.

"Babies have an average of 10-to-15 painful procedures per day in this unit if they're under 30 weeks gestation, or if they're really sick like Josie was," said Dr. Whit Hall.

Besides fighting for her survival, doctors have been wrestling with another issue: With everything that's been done to her, how much pain is Josie feeling?

As recently as 15 years ago, it was thought that newborns were not developed enough to feel or remember pain. Amazingly, newborns often received little or no anesthesia for most medical procedures - even surgery.

"The folklore became babies don't feel pain, anesthesia is bad for them, let's not give anything," said Dr. K.J.S. Anand.

Gupta said: "What you're describing must have been torture for these babies."

Anand is a leading researcher on how to detect pain in these tiny patients who can't speak and spend most of their time sleeping.

Doctors monitor some of the physical signs of pain, like blood pressure and heart rate, and the obvious behavioral signs like crying and facial expressions. But how do you know the difference between a cry of pain or a cry for hunger?

"You just can't stand over an infant 24-7 and watch them. And that's why I thought a machine system would be pretty good at handling some of these problems," said computer scientist Sheryl Brahnam.

Brahnam works with facial recognition technology to identify key spots in a baby's face that signal pain.

"It's wrong to think that every time a baby experiences pain, they'll cry. They're not. Sometimes all you see is a bulging forehead," Brahnam said.

She's working with facial recognition technology to identify key spots in a baby's face that signal pain. The hope is that one day a camera would constantly monitor the faces of newborns and alert doctors to even the subtle signs that something is wrong.

"It gives the infant a voice, it lets the infant cry out, 'I'm in pain,'" Brahnam said.

Detecting pain in newborns is one thing. Treating it is another.

Unfortunately, the drugs to treat babies' pain are meant for adults. Like morphine and methadone. Even today there is reluctance by doctors and parents to use them.

"Yes, I think there are still medical physicians, nurses, who hold out that babies probably don't feel pain," Anand said.

Some of the techniques to calm babies are tried and true: creating a quiet atmosphere with low lights and swaddling them for comfort.

It's all working for Josie.

"Can you say without a doubt, that Josie is not in pain right now?" Gupta asked Hall.

"I can. I'm basing that on she seems comfortable, she's not crying, she seems to be happy," Hall said.

Evidence that years later, children and adults remember the pain they suffered as babies. Studies show they're more pain sensitive and can have higher rates of ADD.

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Doctors at Arkansas Children's Hospital say little Josie's feeding tube has now been removed and she's due to have the first breast feeding of her life. She should be going home in just a few days.

[cklee2]

Thank you for this story. For opening my eyes, as I never thought this would happen these days of discovery. To think that my sons might of went through pain during thier surgery makes me wonder what else was I not told. I assumed that they was being given something for pain, they looked like they was sleeping but could they just been given curare? ".... to paralyze their muscles for surgery, making it impossible for them to lift a finger or make a sound in protest!"
Makes me so angry at myself for taking things like this for granet and even now not wanting to believe this could possibly still be going on in this country.

[pastor365]

Babies are able to remember pain and they can be traumatized from sever pain. I was severely burned at 7 months of age and I had recurring nightmaes for all of my childhood and teenage years from the burn. Later, I was able to tell my mom in detail the color of the walls and floor of the room in which I was burned, and how I received the burn. I still have a fear of hospitals and still cannot walk into a doctors office without becoming afraid because I was also traumatized by the required treatment in the hospital. I know that they were only trying to help me, but I still fear them. I have a friend who is a nurse and she tells me that this is a normal reaction to treatment for a severe burn. I even have a few memories from before I was burned.

[rf35]

"Evidence that years later, children and adults remember the pain they suffered as babies. Studies show they''re more pain sensitive and can have higher rates of ADD."

Perhaps ADD is so common in America because of routine circumcision. As far as remembering pain, the subconscious mind remembers. The brain remembers and stores everything it is exposed to, the conscious mind just has difficulty recalling it.

[snoopy28173]

Finally, I now know why I''m hypersensitive to pain and have ADD. I''m 34 and have had somewhere over 50 operations. As a formal day care teacher, I could tell when a baby was in pain or hungry. I reconized thier cries.

As far as the old theory that babies don''t experience pain, that''s a crock. Why do babies cry when the get a shot? Why do they pull their ear when their ear hurts?

[rushman71]

"Evidence that years later, children and adults remember the pain they suffered as babies. Studies show they''re more pain sensitive and can have higher rates of ADD."

Here''s another thing to think on. Do you think because of all the needles and whatnot, that this could lead to Post Traumatic Stress Disorder (PTSD).
I think todays psychologist and doctors are going WAY too far. Uhh, take a chill pill--Valium!!!

[rushman71]

Tell me, people, do you even REMEMBER being at that age? I didn''t think so. Now, I am not saying that babies don''t feel it, but with the way things have been going the past few years, they are now close to labeling this as "cruel and unusual punishment", just like circumcision. Oh, the humanity!!! What are we turning ourselves into!!!

[dianle]

I agree, babies feel pain, especially those killed by abortion-those who have their bains sucked out in partial birth abortion, and those murdered in the womb.

[grammawhamma]

Of course babies feel pain....that includes the ones killed in late term abortions!