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How to Tell if an Infant Is Crying in Pain, or Just Crying

13 MAY 2015

It can be so hard for parents to tell if their young kids are in pain. Babies cry so much, how can you know you're not going to raise the alarm unnecessarily? A recent study has looked at how effective 333 adults were at identifying if a baby was distressed based on the sounds of their cries.


The adults listened to recordings of five- to 10-month-old babies and were asked to identify if they were recieving vaccinations, hungry, separated from their parents, just fed or playing. Turns out, the adults were actually pretty good at telling if the baby was distressed, but not so good at identifying what the cause of that distress might be.

An ability to pick up on their distress makes sense in terms of evolution, Julie Gros-Louis, a developmental psychologist at the University of Iowa in the US, told Jessica Hamzelou at New Scientist. "There is a hypothesis that suggests that negative vocalisations have a direct effect on listener's attention, arousal and affect," she said.

Believe it or not, for years, medical professionals believed that babies simply don’t feel pain. Obviously they were sorely mistaken, and many babies were exposed to unneccrsary pain without proper treatment because of this. And while that's no longer the case, a recent study found that while the average baby in intensive care has 11 painful procedures each day in their first two weeks of life, less than 40 percent received any pain relief. "We need better ways to measure infant pain if we want to develop more effective treatments," neuroscientist Rebeccah Slater from the University of Oxford in the UK writes at the Wellcome Trust blog.

Slater is using brain-imaging to see inside the minds of newborns to try to improve pain management. She's currently using fMRI to show that newborn infants "have the sensory and emotional capacity to experience pain in a similar way to adults." After this, she'll examine whether morphine can be used as pain relief for infants. "Historically, there has been a predisposition to undertreat pain in babies," she says. "In part, this has arisen because it is difficult to measure infant pain. As babies can’t tell us when they are in pain, it can be hard to assess whether pain medication is working."

Slater and her colleagues are working on changing this by showing that the infant brain is activated during painful procedures. "Nevertheless, little is known about which parts of the brain are involved in the infant pain experience or how this information is interpreted," she says.

This is all the more important, as pain in infancy can have long-term behavioural and cognitive effects. These include altering the brain's microstructure, poorer cognitive outcomes when the baby is a toddler, and lower IQ long-term, research has found.

It can be all the more tricky to know what's going on for a baby, Slater says, because with the immature developing nervous system an infant may "cry and grimace" but their "behavioural responses are not necessarily well correlated with the experience of pain."

Watch below to see Slater talk about her research: