Where the baby is to undergo some form of planned procedure, health professionals will take steps to reduce pain to a minimum, though in some circumstances it may be not be possible to remove all pain. In case of illness, accident and post operative pain, a graded sequence of treatment is becoming established as standard practice. Research is making it easier and simpler to provide the necessary care, with a clearer understanding of the risks and possible side effects. Measures not involving medication Comforting Touching, holding, stroking, keeping warm, talking and singing/music are ways in which adults have been comforting<unk>  since the start of human history. This way of managing pain is shared with other primates, where the actions are performed both by female and male adults. Children who are able to verbalise pain report it to be an ineffective strategy and this is assumed to also be true of<unk> . While the pain of a procedure may or may not be affected, the fear is visibly reduced. This works to ameliorate the negative effects of fear in health care situations. It is, therefore, considered good practice to involve parents or care-givers directly, having them present and in contact with the baby whenever possible before a minor painful procedure, such as the drawing of blood, or prior to giving a local anaesthetic injection. Oral stimulation Breastfeeding, the use of a pacifier and the administration of sugar orally has been proven to reduce the signs of<unk> . Electroencephalographic changes are reduced by sugar, but the mechanism for this remains unknown; it does not seem to be endorphin mediated. As in comforting, it is unknown whether the physical pain is reduced, or whether it is the level of anxiety which is affected. However, the reduction in pain behaviour is assumed to be accompanied by a reduction in pain-related disorders, both immediate and longer term. Oral sugar Sugar taken orally reduces the total crying time but not the duration of the first cry in newborns undergoing a painful procedure (a single lancing of the heel). It does not moderate the effect of pain on heart rate and a recent single study found that sugar did not significantly affect pain-related electrical activity in the brains of newborns one second after the heel lance procedure. Sweet oral liquid moderately reduces the incidence and duration of crying caused by immunization injection in children between one and twelve months of age. Sensorial Saturation It is based on the competition of various gentle stimuli with pain transmission to the central nervous system: the so-called gate control theory of pain (proposed by Patrick David Wall and Ronald Melzack in 1965). Sensorial saturation follows a “3Ts” rule: using touch, taste and talk to distract the baby and antagonize<unk>  treated with Sensorial Saturation, a reduction in crying time and pain score were noted, with respect to a control group and with respect to groups in which only oral sugar, only sucking, or a combination of the two was used. The "3Ts" stimuli (touch, talk, and taste)given throughout the painful procedure increase the well-known analgesic effect of oral sugar. Sensorial Saturation has been included in several international guidelines for analgesia Other techniques Other "old fashioned" techniques are being tested with some success. "Facilitated tucking", swaddling and "kangaroo care" have been shown to reduce the response of<unk>  to painful or distressful circumstances, while a comprehensive technique of nursing, called "developmental care", has been developed for managing pre-term infants. Measures involving medication Local anaesthetics A variety of topical anaesthetic creams have been developed, ranging from single agents with good skin penetration, to eutectic mixtures of agents and technologically modern formulations of lignocaine in microspheres. They are effective in suitable procedures, if correctly and timeously applied. Disadvantages are the slow onset of adequate anaesthesia, inadequate analgesia for larger procedures, and toxicity of absorbed medication. Local infiltration anaesthesia, the infiltration of anaesthetic agent directly into the skin and subcutaneous tissue where the painful procedure is to be undertaken, may be effectively used to reduce pain after a procedure under general anaesthesia. To reduce the pain of the initial injection, a topical anaesthetic ointment may be applied. Regional anaesthesia requires the injection of local anaesthetic around the nerve trunks that supply a limb, or into the epidural space surrounding the spinal cord. It is used for pain relief after surgery, but requires special facilities for observation of the baby until the effect has worn out. Analgesics As the site of<unk>  is difficult to confirm, analgesics are often advised against until a proper diagnosis has been performed. For all analgesic drugs, the immaturity of the baby’s nervous system and metabolic pathways, the different way in which the drugs are distributed, and the reduced ability of the baby to excrete the drugs though the kidneys make the prescription of dosage important. The potentially harmful side effects of analgesic drugs are the same for<unk>  as they are for adults and are both well known and manageable. There are three forms of analgesia suitable for the treatment of<unk> : paracetamol (acetaminophen), the nonsteroidal anti-inflammatory drugs, and the opioids. Paracetamol is safe and effective if given in the correct dosage. The same is true of the nonsteroidal anti-inflammatory drugs, such as ibuprofen (aspirin is seldom used). Of the opioids, morphine and fentanyl are most often used in a hospital setting, while codeine is effective for use at home. Clonidine is thought to have potential to reduce pain in newborn<unk>  but it has yet to be tested in clinical trials.
Pain in babies
Infant crying
Breastfeeding difficulties
Chest pain in children
symptoms of Birth defect
Undernutrition in children
Omphalitis of newborn
Birch