The impact of pain and analgesia on neurodevelopment, psychosocial wellbeing, and growth in neonates and infants in the NICU

Pain experienced by neonates and infants in the neonatal intensive care unit (NICU) not only has an impact on the comfort and wellbeing of the infant, but may have long-lasting consequences beyond discharge. Although the idea that pain in NICU has detrimental effects on the physical health of neonates and infants has been around for 24 years, further research suggests that neonatal and infant may lead to later effects in 1) alterations in pain processing, 2) poor neurodevelopmental outcomes, 3) adverse changes in brain development, 4) poor growth, and 4) adverse effects on the psychosocial wellbeing. Furthermore, the impact of pharmacological pain relief in these infants on various outcomes such as neurodevelopment has produced mixed results. As research in this area continues, new directions of research are necessary. For example, nothing is known about the role of chronic pain on neurodevelopmental, psychosocial wellbeing, and growth. Moreover, various populations of infants are systematically excluded in research on outcomes which means that findings of currently available studies may not extrapolate to all infants in the NICU. The presentation will conclude with suggestions for future research to drive much-needed progress in the area of pain in neonates and infants in the NICU.