Mediating Infant Pain

"In the mid-'80s, babies were receiving open-heart surgery with no anesthesia."

"Even if those little ones did not have the words at that time, their bodies remember and we see the long-term consequences of that in their physical and psychological development."

Dr. Samina Ali, professor of pediatrics, adjunct professor of emergency medicine, University of Alberta

"If I think about it from a training standpoint, there's a huge need."

"About one in every five children has chronic pain."

"It puts them at increased risk for mental health issues, substance use and socioeconomic disparities into adulthood."

Dr. Katie Birnie, psychologist, associate scientific director, Solutions for Kids in Pain 

The Health Standards Organization released a new set of guidelines to help hospital workers manage pain in children -- particularly for those who can't communicate when they're hurt. THE CANADIAN PRESS/AP-Amr Alfiky

 

A new set of guidelines for the purpose of helping hospital workers manage children's pan -- in particular for those who are unable to communicate when they're hurt and suffering -- has been released by the Health Standards Organization in Canada, the first such national standard in the world, entirely focused on pediatric pain.

Dr. Samina Ali, an emergency physician and pediatric pain researcher, explains that doctors conventionally believed that young children's nervous systems were undeveloped to the point they would be unable to feel or remember having suffered pain. This belief persisted until relatively recently when closer study of the issue made it obvious enough that babies and toddlers are susceptible to pain and that medical professionals should acknowledge this as fact and act upon it to mitigate their suffering.

Canada has made that a lesson in pain management for babies and infants to produce major strides toward correcting that misapprehension, and to standardize the approach cross-country reflects the current trajectory. In hospital, children experience an average of six painful procedures every day, according to Katie Birnie, psychologist involved in Solutions for Kids in Pain. An estimated 14 painful encounters is experienced by babies in intensive care.

Issues to be aware and treat pain management for young patients, including mandatory incident reports, when a patient experiences preventable, untreated and unmanaged pain are laid out through identifying 34 criteria produced in the new standards. Also recommended is ongoing training for health-care providers within the standards. Making certain that each patient is being constantly assessed for their pain, and whether treatments are benefiting the children is also incorporated into the new standards.

The guidelines are set to be made available to hospitals and health workers, steered by Accreditation Canada and Health Standards Organization. The expectation is that before long the standards will form the basis of policy and training for health-care professionals.

Pediatric resident at British Columbia's Children's Hospital in Vancouver, Dr. Justina Marianayagam can personally recall only one lecture on pain management in her four years of training; an hour of pain management in an introduction course, nothing more. "If I think about it from a training standpoint, there's a huge need", she said. She had intimate experience of her own with the issue, having suffered chronic pain as a child.

A child's emotions, their friendships, their family relationships, sleep and physical functioning can all be affected by pain. It has been observed that Black, Indigenous or otherwise distinguished children by ethnic origin, or poverty experience discrimination and inequity, making them disproportionately impacted, points out Dr. Marianayagam.

An empty cot sits outside an operating theatre in Toronto's Hospital for Sick Children . THE CANADIAN PRESS/Chris Young