Neonatal Pain

A newborn cannot describe a burning heel lance, an inflamed abdomen, or the discomfort of an endotracheal tube. Pain must therefore be inferred from a pattern: facial and body responses, changes in state and breathing, and physiological shifts that occur with the stimulus. Crying is only one part of that pattern; an intubated infant cannot cry, and a fatigued or severely distressed infant may become quiet rather than louder. The practical sequence is consistent: measure pain with a validated tool, reduce the stimulus and provide developmentally appropriate comfort, add prescribed analgesia when the procedure or score warrants it, then repeat the assessment. The same score before and after a procedure shows whether the intervention worked. Apnea, bradycardia, marked tachycardia, haemodynamic instability, or a very high score changes the priority from routine comfort to immediate assessment and escalation.