Newborns Can Remember Pain, May Also Possess Short-Term "Pain Memory"

By Dr. Paul Ranalli, M.D.

image-097Evidence that newborn babies are not only capable of feeling pain, but may possess a short-term "pain memory," will likely add fuel to the upcoming firestorm over the practice of late-term abortion, particularly partial-birth abortion.

 

In the new study, published in the August 21 edition of the Journal of the American Medical Association (JAMA), by pediatric pain experts at the Hospital for Sick Children at the University of Toronto, the pain response of newborn babies of diabetic mothers were compared with babies born of non-diabetic mothers.

When a diabetic mother gives birth, her baby's blood sugar is monitored closely over the first 24 hours.  Blood is drawn by the standard "heel lance" method, in which the baby's heel is first cleaned with a swipe from an alcohol swab, then is jabbed with a sharp metal instrument just above the heel, to express a few drops of blood. The heel is lanced one hour after birth, then every 2 to 4 hours afterward, throughout the baby's first day.

After 24 hours, all 42 babies (of both diabetic and non-diabetic mothers) undergo a venipuncture, in which a small needle is inserted into a vein on the back of a hand, to collect blood for a number of routine newborn tests. The pain experts observed and measured the pain response of the babies during the venipuncture, noting the degree of crying, facial grimacing, and body movement.

The result:  the maternal-diabetic babies, who had undergone several painful heel lances over the preceding 24 hours, displayed a larger pain response than babies of non-diabetic mothers, who were being punctured for the first time.

image-098More astonishing yet, 22 percent of the maternal-diabetic babies began to grimace before the puncture, during the preparatory skin cleaning. None of the other babies displayed this anticipatory response.  Dr. Anne Taddio and her colleagues postulated that the skin cleaning had become a sort of conditioned stimulus, and concluded, "These data provide further evidence that infant pain is modulated by experience with pain, as in children and adults."

That newborn babies feel pain is not news to those who have paid attention to pain research over the past one-and-a-half decades. However, until the mid-1980s, newborns were simply assumed not to feel pain, or to perceive it only minimally.  In what is now universally regarded as an erroneously barbaric practice, major surgery used to be performed on newborn babies with little or no anaesthesia.

By 1987, these assumptions were demolished by a growing body of evidence best summarized in a seminal article by pain authority Dr. K.J. Anand, who reviewed the data which measured the changes in heart rate, blood pressure, breathing pattern, and stress hormone secretion in infants suffering pain.

When infants were given proper relief during surgery, not only did these physiological responses settle down, but more babies survived major surgery. Furthermore, several lines of evidence began to reveal that babies born prematurely are even more acutely sensitive to pain than full-term newborns.

What is truly new about this latest study is the revelation of just how sophisticated the newborn baby's brain is, in its ability to register the experience of pain and file it away in a short-term pain memory.  And not just the pain itself, but a memory of heightened awareness of sensations surrounding the pain experience, in this case, the wet stroke of the preceding alcohol swab across the skin. This suggests the oft-reported vivid memory adults describe of sensations associated with a traumatic experience, such as pain, fear, or assault - - a clear memory of an ordinary visual scene, a smell, a sensation. In this case, day-old newborn babies were able to link the subtle sensation of having their heel wiped by an alcohol swab with an anticipated jab of pain.

One of the arguments raised against the significance of data demonstrating fetal pain is that the unborn do not possess adequate enough cerebral cortical development to really "feel" pain beyond a reflex level, and certainly do not have the ability to feel pain in context, compare it with earlier experiences, to have enough brain power to truly experience suffering at a conscious level.

Certainly this is true at an early enough stage in fetal development.  But this current study suggests that a newborn's power of pain perception is highly advanced at day one, including, presumably, premature babies. The question is:  how far back in fetal development does this pain awareness go?

We know from anatomical studies that the entire pain pathway system (the spino-thalamic tract) is assembled by 20 weeks' gestation. Stress hormone release from fetuses has been recorded at 18 weeks, and changes in fetal brain circulation in response to pain have been observed at 16 weeks. At 20 weeks, the fetal brain has the full complement of brain cells present in adulthood, and brain wave recordings are detectable at 19 weeks.

In testimony to Congress in 1995, U.S. pediatric neurosurgeon Dr. Robert White stated, "In summary, then, the fetus within this time frame of gestation, 20 weeks and beyond, is fully capable of experiencing pain."

Since premature newborns are viable, and visibly sensitive to pain, from 23 weeks' gestation onward, the pain system is clearly operating at this stage. Partial-birth abortions target the unborn from 20-26 weeks' gestation.

More recent concepts of pain perception point to the importance of brain chemicals "Substance P" and "enkephalin," which are detectable in the fetal brain at 11 weeks and 13 weeks, respectively. Even among abortion-performing physicians in England and France, a consensus is building that consideration should be given to administer analgesia specifically for the fetus in late-term abortions.

This latest study on newborn pain perception and pain memory draws sharper attention to the awful reality, still too successfully denied by abortion advocates, of the suffering experienced by near-born infants in late-term abortions.  They know that people would be horrified if the truth be known.  No wonder they must deny it.
 

Reprinted with permission from the author. 2004