A nurse in Australia recently described her master's degree research project to us. "My research is about trying to reduce baby's pain during heelpricks in the neonatal ICU," she said. "Our long-term babies may have 30, 40, 100 heel pricks during their admission. So we are trying to reduce their crying and pain during the heel-prick procedure by giving them sucrose on their tongues during and after the procedure."
As far as it goes, this brief description makes the research project seem worthwhile but there is nothing particularly compelling or important about it. It's nice. When we asked the researcher to elaborate further, we discovered that the the impetus for the project was not the fact that babies cry when they get a needle stick but that they can become so distressed they could actually die. This significant piece of information was missing from her description. When we asked more questions, a very different—and far more compelling—picture of the research emerged.
"The heels of very sick babies are pricked to test their blood. We prick them on their heel, which is very sensitive part of their body, without using an anesthetic. The conventional wisdom has been that babies don't feel pain or that if they do, they forget it. As nurses we know that babies obviously do feel pain. They cry in high-pitched voices and screw up their faces and kick their legs out. Their heart rates increases to 200 beats per minute. They begin to pant. When babies are very sick, particularly babies with heart conditions, they can become blue and some have had a cardiac arrest during the heel-prick procedure. Although it's rare, there have been babies who have died. I worked with a baby who arrested and died which prompted me to do my study. What they go through in an ICU can affect their growth and development in later years. So if we can do anything to reduce their pain during the heel-prick procedure, it can have a very significant effect while they are on and when they get off the unit."
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