*Do Babies Really Feel Pain? *
*
*
*
Do babies feel pain? I certainly think they do, but, to find out, we should
not have stuck them with pins. There are other objective indications of
pain.
.
1. Crying. It seems perfectly obvious now, but for a long time, experts were
informing the public that infants cries were only "random" sounds, not
genuine communications. It took a quarter century of cry research to prove
otherwise. *
**
* Cries are not only meaningful signals, but often compelling ones. They
increase in intensity with degrees of pain. Spectrographic studies that
reduce sound to an elaborate visual portrait show just how varied and
complex cry language is. Acoustic studies show that changes in pitch,
temporal patterning, and harmonic structure also reflect the degree of pain
and urgency. For example, in a thorough study of cries during circumcision,
acoustic features precisely reflected the degree of invasiveness of the
surgery.
.
Parents present at circumcision (a rarity) have recalled how their babies
cried. One father, present in the delivery room told me of his great
surprise when the obstetrician proceeded to circumcise this boy at delivery.
Having been quiet through the entire birth, the boy proceeded to protest
loudly about the circumcision! A Jewish father, reflecting on this boy's
circumcision on the eighth day, said it was the saddest occurrence of his
babyhood: the boy cried more that afternoon, he said, than anytime in his
whole first year.
.
2. Facial expressions. Second, the pain that babies feel is clearly
expressed on their faces. Brows bulge, crease, and furrow. Eyes squeeze
shut: bulging of the fatty pads about the eyes is pronounced. There is a
nasolabial furrow that runs down and outwards from the corners of the lip.
Lips purse, the mouth opens wide, the tongue is taut, and the chin quivers.
This look on a human face of any age communicates pain. Why do we doubt that
it means the same on the face of a baby?
.
3. Body movement. Body language in its larger motor dimensions is also a
language that babies share with older humans. In response to pain, babies
jerk, pull back, try to escape, swing their arms, use their hands to push
away, and frantically scrape one leg against the other to dislodge an
offending stimulus in that area. They strike out with their upper
extremities and kick with the lower.  Receiving routine heel lancing, a deep
wound made in the heel to obtain blood samples. Using calibrated hairs, they
gently stroked the corresponding areas in the injured and non-injured heel.
Even premature infants showed the same well-defined hypersensitivity to
tissue injury that is found in adults. *

*.
4. Vital signs. Fourth, we can see how baby pain is revealed by changed in
vital signs and blood chemistry. Pain causes increased respiration. Babies
hold their breath and release it in piercing cries. Researchers have
observed infant heart rates increase 50 beats per minute and peak above 180
beats per minute.  In a study to compare behavioral states of the newborn to
those of the fetus, Pillai and James  discovered that the heart rate during
newborn crying was unlike anything seen in prenatal life. This racing
heartbeat was unstable, often reaching peaks in excess of 200 bpm, in spite
of the fact that baseline heart rates after birth are generally 20-25 bpm
lower than they are in utero. These extremely elevated heart rates signal a
serious and urgent disturbance.
.
Serum cortisol is a measure of stress. In painful conditions, adrenals may
release cortisol three to four times the baseline. In one study, cortisol
levels clearly differentiated between three different surgical techniques of
circumcision.
.
Under painful conditions, tissue and blood oxygen levels drop.
.
5. Neurobehavioral assessments. Further consequences of infant pain can be
seen in neurobehavioral assessments. Babies who have been subjected to pain
may have difficulty quieting themselves. Following circumcision, the normal
progression of sleep cycles is reversed with immediate and prolonged escape
into Non-REM sleep. After circumcision, babies withdraw, change their social
interactions with their mothers, and modify their motor behavior. *
  **

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