Managing Pain in Preemies

preemieWith the advancements in modern medical technology, preemies and even micro preemies now have a much better survival-rate than ever before.  Babies that even a few decades ago would have had little chance of lasting a few hours outside the womb are now thriving.  Of course, with all of this medical intervention comes a lot of poking, prodding and potential pain for the premature neonates.  Pain isn’t just painful for these little ones, combined with the associated stress, it can actually impair their development.

How to Reduce Pain and Stress

Morphine has long been used for pain management in preemies.  It is relatively well-tolerated and a great go-to option for dealing with moderate to severe pain.  However, when babies are so small and under-developed that even a diaper change can be stressful and painful, morphine isn’t always indicated or appropriate.

Because being exposed to stress and pain can actually impair development, it’s imperative that it be managed somehow.  The natural coping method for an infant is to suck.  However, due to intubation and their tiny little mouths, pacifiers aren’t always feasible for preemies.  That is, until now.

A New Tool

Because standard pacifiers were not intended to be used by preemies or in conjunction with intubation, they were often a failed option.  While they could give comfort, not being able to properly suckle on them could actually lead to more stress.  That was until a new pacifier was born.

Smaller, and with a notch designed to work around intubation tubes without adding additional bulk, these new pacifiers have provided a dependable way to eliminate or reduce pain naturally and un-invasively.   The intuitive sucking allows babies to cope, and many caregivers and scientists alike speculate that it actually interferes with the perception of pain.  This in effect makes the baby perceive a higher level of comfort, even when stressed or in pain.

Does the Pacifier Really Help?

Research on over a dozen babies exposed to moderate pain (routine heel sticks) with and without the pacifier have demonstrated a marked difference in their reactions to painful stimuli.  Preemies who had access to the new pacifier during their procedures had both lower heart rates and better oxygen stats than those without.

So, what does this mean?  It opens up an entirely new way of caring for preemies.  It preserves their development by preventing their exposure to undue stress and pain.  It also provides peace of mind to parents and caregivers alike.

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Could Your Antidepressant Be Risking your Newborn’s Health?

Antidepressant use in America is currently higher than it has ever been in the past.  Somewhere around 13% of Americans take an antidepressant every day, a number that’s climbed over 400% since 1982.  With so many people relying upon pharmaceutical assistance to maintain their mood, and with many of the antidepressants currently prescribed being fairly new, it’s no surprise that we’re still discovering new associated health risks that go hand in hand with their use.

Persistent Pulmonary Hypertension of the Newborn

health riskAlso known as PPHN, is a serious, sometimes life-threatening complication that is defined when a newborn is unable to breathe on their own outside the womb.  It is the result of high blood pressure, and it claims the lives of up to 20% of newborns afflicted.

Even in cases where infants survive, the repercussions of low blood oxygen can be profound and lifelong, ranging from developmental disorders to lung disease.

Back in 2006, the FDA recognized a potential association between SSRI antidepressants and instances of PPHN in newborns.  They advised patients to avoid the use of these drugs during the last 90 or so days of gestation due to a perceived association with the deadly affliction.

A Change in Stance

Despite their clear 2006 warning, the FDA back peddled a bit in 2011, indicating that perhaps their original warning had been erroneous.  That no clear association between the SSRI’s and PPHN was known, and that pregnant women should remain on their prior depression treatment regimen throughout their pregnancy.

This confusing change of stance prompted researchers from Brigham and Women’s Hospital in Boston to do some more digging in a widespread study of their own to clarify.

The Results

In the largest study off its kind, which sampled almost 4 million pregnant women in 46 states, the colleagues gathered some statistics.  Their results were fairly conclusive, given the broad statistical sampling, which was gathered by following women for the last 90 days of their pregnancy and their newborns for an additional 30 days.

Overall, there was an increased instance of PPHN among all antidepressant users, not just those using SSRI’s.  However, those exposed to SSRI’s during the last 90 days of gestation had the highest instances.  The rate of PPHN was 20.8:10,000 among totally unexposed newborns, 29.1:10,000 among those exposed to non-SSRI and 31.5:10,000 among those exposed to SSRI’s.

The bottom line is that there is an increased risk to fetal development when antidepressants are used during late pregnancy.  However, this is a risk that must be assessed and evaluated with the risk of stopping/changing depression treatment.