Pain management for infants: Myths, misconceptions, barriers; knowledge and knowledge gaps

Abstract

Twelve years ago, the paper ‘Oral sucrose for pain management in infants: Myths and misconceptions’ was published in the Journal of Neonatal Nursing. At this time, eight myths or misconceptions were addressed. Since this time there has been more than 100 studies published reporting on analgesic effects of sweet solutions in newborns, which have been synthesised and included in systematic reviews. There has also been a growth of literature to support analgesic effects of breastfeeding and skin-to-skin care as well as concerning evidence of adverse long-term neurobehavioural outcomes associated with painful procedures. Yet, ongoing studies of pain management practices continue to report inconsistent use of these strategies during painful procedures. We are therefore at a cross-roads of evidence – there is knowledge of effective treatments, knowledge of harm of untreated pain, yet sick, premature as well as healthy infants are continuing to be exposed to painful procedures with no effective treatment. There are however ongoing myths, misconceptions, and practical barriers to using the evidence as well as ongoing knowledge gaps. This paper will therefore highlight existing myths, misconceptions, barriers and current knowledge gaps to using the three key evidence-based pain management strategies of breastfeeding, skin-to-skin care and sweet solutions, in the hope that this will bring to light newborn infant pain treatment practices that can be improved.