Newborn, Pain, Procedural Pain, Non-pharmacological Methods, Newborn Screening

IntroductionAccording to the methodological instruction of the Ministry of Health in the Bulletin of the Ministry of Health of the Czech Republic No. 6/2016, capillary blood sampling (neonatal screening) is performed on every child between 48 and 72 hours of age. Newborn screening is used to search for diseases at an early stage. The experience of pain, even if only procedural, has a negative impact on the health of the child, so it is important to control pain in newborns primarily by non-pharmacological methods.ObjectiveThe main objective is to determine which multisensory interventions are most effective for procedural pain in newborns, specifically in newborn screening. And which risk factors may be related to the experience of pain.MethodsQuantitative research is conducted by taking video recordings of newborns with the consent of the legal guardian during newborn screening. After viewing the video recordings, the recordings are carefully examined and pain rating scales will be completed based on the newborn's expressions. Pain will be assessed using the Newborn Infant Pain Scale (NIPS) and the Newborn Facial Coding System (NFCS).ResultsA pilot study conducted on 20 newborns showed that newborns who were breastfed during newborn screening showed lower rates of experiencing pain. Breastfed newborns achieved an overall mean score on the NIPS scale during collection of 1.50 (median=1.5), while for newborns who were not breastfed it was a mean score of 2.67 (median=3.00). However, the Mann-Whitney test (p=0.139) and Fisher's exact test (p=0.613) did not confirm significance at the p=0.05 significance level.The mean score for the NFCS scale in breastfed neonates during collection was 1.57 (median = 1.00) while in non-breastfed neonates it was 3.83 (median = 4.50). Thus, neonates who were not breastfed showed higher rates of experiencing pain. A Mann-Whitney test (p=0.011) was then performed and confirmed significance at the p=0.05 level of significance. However, the Fisher's exact test (p=0.051) did not confirm at the p=0.05 level of significance the significance of differences in the frequency of pain experience between infants who were breastfed and those who were not.ConclusionPain, especially in young children, is still often downplayed and myths persist about the experience of pain in young children, e.g. that the child does not remember pain, does not feel pain or that children do not need to be numbed because they tolerate pain well. Research clearly shows that the pain pathways, as well as the brain centres for pain perception, are already well developed in premature babies.

IntroductionAccording to the methodological instruction of the Ministry of Health in the Bulletin of the Ministry of Health of the Czech Republic No. 6/2016, capillary blood sampling (neonatal screening) is performed on every child between 48 and 72 hours of age. Newborn screening is used to search for diseases at an early stage. The experience of pain, even if only procedural, has a negative impact on the health of the child, so it is important to control pain in newborns primarily by non-pharmacological methods.ObjectiveThe main objective is to determine which multisensory interventions are most effective for procedural pain in newborns, specifically in newborn screening. And which risk factors may be related to the experience of pain.MethodsQuantitative research is conducted by taking video recordings of newborns with the consent of the legal guardian during newborn screening. After viewing the video recordings, the recordings are carefully examined and pain rating scales will be completed based on the newborn's expressions. Pain will be assessed using the Newborn Infant Pain Scale (NIPS) and the Newborn Facial Coding System (NFCS).ResultsA pilot study conducted on 20 newborns showed that newborns who were breastfed during newborn screening showed lower rates of experiencing pain. Breastfed newborns achieved an overall mean score on the NIPS scale during collection of 1.50 (median=1.5), while for newborns who were not breastfed it was a mean score of 2.67 (median=3.00). However, the Mann-Whitney test (p=0.139) and Fisher's exact test (p=0.613) did not confirm significance at the p=0.05 significance level.The mean score for the NFCS scale in breastfed neonates during collection was 1.57 (median = 1.00) while in non-breastfed neonates it was 3.83 (median = 4.50). Thus, neonates who were not breastfed showed higher rates of experiencing pain. A Mann-Whitney test (p=0.011) was then performed and confirmed significance at the p=0.05 level of significance. However, the Fisher's exact test (p=0.051) did not confirm at the p=0.05 level of significance the significance of differences in the frequency of pain experience between infants who were breastfed and those who were not.ConclusionPain, especially in young children, is still often downplayed and myths persist about the experience of pain in young children, e.g. that the child does not remember pain, does not feel pain or that children do not need to be numbed because they tolerate pain well. Research clearly shows that the pain pathways, as well as the brain centres for pain perception, are already well developed in premature babies.