Abstract
Increases in medical expertise and technological advances have enabled the survival of very preterm babies who form a new and growing population. Comparisons between the foetus, full-term baby and the very preterm baby indicate that by the time the foetus is of 23 weeks gestation, many of the abilities, for example, sensing touch, hearing, seeing, moving and even learning may be common to all three. Thus, the very preterm infant who has been described as a unique organism, is not passive, but is a sentient being who is unlikely to survive without the medical and technical support of the Neonatal Intensive Care Unit (NICU) where he/she is exposed to frequent and regular medical procedures. Many of these procedures would be, for any normal, fully developed human being at best uncomfortable and at worst painful. Reviews within the past 10 years have shown that the neurochemical, anatomic and functional systems of newborns are developed enough to perceive pain. More importantly, rat pup studies have indicated that not only may the very preterm baby experience pain but it may experience it more intensely than the more mature infant. Moreover, there may be serious consequences of repeated painful medical intervention. Alleviation of pain and/or distress in very preterm infants is, therefore, an important issue.
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