Pain in Premature Infants: What Is Conclusive Evidence and What Is Not

Premature infants spend much of their early days of life in an environment that is stressful and in many situations painful. Short and long term consequences of pain are not well documented, yet postulated to have a negative impact on stress-response systems and on deployment. To date there is insufficient evidence for the best methods to assess or to effectively treat their pain. Though a variety of uni- and multidimensional assessment tools are available, many lack sufficient psychometric testing, do not incorporate essential developmental cues to premature infants, and do not distinguish between acute and chronic pain. This review paper will discuss the etiology, sources, and manifestations of pain as well as the short and long term consequences of pain. The available assessment tools for pain in premature infants along with reliability and validity will also be presented.