Pain and the neonate

Fletcher, Valerie

doi:10.1007/978-1-349-12936-2_8

Cited by 5 publications

(6 citation statements)

References 41 publications

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“…18,19 Observational studies of boys undergoing circumcision showed short-and long-term changes in physiological stress indicators, disturbed adaptation to the postnatal environment, interference with normal mother-child bonding and disruption of breastfeeding patterns, 2,[20][21][22][23] although a recent, small study failed to confirm an impact on breastfeeding. 24 Neonatally circumcised boys in Canada exhibited significantly more signs of discomfort during routine vaccinations 4-6 months later than boys who were left intact, showing that early life trauma may alter a child's future handling of pain.…”

Section: Introductionmentioning

confidence: 99%

Ritual circumcision and risk of autism spectrum disorder in 0- to 9-year-old boys: national cohort study in Denmark

Frisch

2015

J R Soc Med

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Objective: Based on converging observations in animal, clinical and ecological studies, we hypothesised a possible impact of ritual circumcision on the subsequent risk of autism spectrum disorder (ASD) in young boys. Design: National, register-based cohort study. Setting: Denmark. Participants: A total of 342,877 boys born between 1994 and 2003 and followed in the age span 0-9 years between 1994 and 2013. Main outcome measures: Information about cohort members' ritual circumcisions, confounders and ASD outcomes, as well as two supplementary outcomes, hyperkinetic disorder and asthma, was obtained from national registers. Hazard ratios (HRs) with 95% confidence intervals (CIs) associated with foreskin status were obtained using Cox proportional hazards regression analyses. Results: With a total of 4986 ASD cases, our study showed that regardless of cultural background circumcised boys were more likely than intact boys to develop ASD before age 10 years (HR ¼ 1.46; 95% CI: 1.11-1.93). Risk was particularly high for infantile autism before age five years (HR ¼ 2.06; 95% CI: 1.36-3.13). Circumcised boys in nonMuslim families were also more likely to develop hyperkinetic disorder (HR ¼ 1.81; 95% CI: 1.11-2.96). Associations with asthma were consistently inconspicuous (HR ¼ 0.96; 95% CI: 0.84-1.10). Conclusions: We confirmed our hypothesis that boys who undergo ritual circumcision may run a greater risk of developing ASD. This finding, and the unexpected observation of an increased risk of hyperactivity disorder among circumcised boys in non-Muslim families, need attention, particularly because data limitations most likely rendered our HR estimates conservative. Considering the widespread practice of non-therapeutic circumcision in infancy and childhood around the world, confirmatory studies should be given priority.

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Section: Introductionmentioning

confidence: 99%

Ritual circumcision and risk of autism spectrum disorder in 0- to 9-year-old boys: national cohort study in Denmark

Frisch

2015

J R Soc Med

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“…The areas of neonatal pain and pain management have recently become important and controversial topics (Anand & Hickey, 1987;Booker, 1987;Dilworth, 1988;Fletcher, 1987;Gauntlett, 1987;Harrison, 1986;Koh, 1987;Lawson, 1986;McGrath, 1988;Poland, Roberts, Gutierrez-Mazorra, & Fonhalsrud, 1987;Pur-cellJones Dorman, & Sumner, 1988;Schechter, 1989;Schoen, et al, 1989;Shearer, 1986;Silverman, 1987). Earlier reports indicate that neonates do not perceive pain as intensely as adults, have a diminished capacity to locate painful stimuli, and recover more quickly from painful insults (Bronstein, 1985;Fitzgerald & Gibson, 1984;Hatch, 1987;Mersky, 1970).…”

Section: Introductionmentioning

confidence: 99%

Nociceptive responses of 3‐day‐old rat pups to IP injection of lithium carbonate

McLaughlin

Cramer

1991

Developmental Psychobiology

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Various authors have suggested that neonatal responses to nociceptive stimuli are different than those observed in adults. However, our own recent observations in rat pups have indicated that neonates may be more responsive to nociceptive stimuli than previously thought. In the present study, the abdominal constrictions or writhing test of visceral nociception was adapted for use in 3-day-old rat pups in an effort to more completely assess the nociceptive responses of neonatal rat pups. Pups receiving the imtant showed robust and long-lasting behavioral differences that were attenuated by morphine sulfate. The results from our study indicate that neonatal rats pups are not insensitive to noxious stimulation as has been previously suggested.

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“…[2][3][4][5] The work of Anand et al 6,7 and others on infants undergoing ductal ligations with little or no anesthesia was a clarion call to look at our practices. 8,9 Additional research documented the negative consequences associated with inadequately treated pain. 9,10 These publications prompted an outpouring of additional research and promoted public awareness of the importance of pain management for children as well as adults.…”

mentioning

confidence: 99%

“…8,9 Additional research documented the negative consequences associated with inadequately treated pain. 9,10 These publications prompted an outpouring of additional research and promoted public awareness of the importance of pain management for children as well as adults. [10][11][12][13][14] By the mid-1990s, research had addressed many of the unique aspects of pain in children.…”

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confidence: 99%

From the Ouchless Place to Comfort Central: The Evolution of a Concept

Schechter

2008

Pediatrics

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Although the past 20 years have yielded an outpouring of research on pain management in children, this information is often not applied uniformly to children in the hospital. To address this deficiency, we developed a systematic institution-wide program to reduce pain in all children in the hospital. Our goal was to create a setting in which attention to pain control and comfort measures would be inherent in all inpatient encounters. We labeled the inpatient unit in which this concept evolved as the "Ouchless Place" and described the program and its development in a 1997 Pediatrics article. In this article we describe the further evolution of that concept in light of the broader changes that have occurred in the field of pain management and in our community. The development of a new children's hospital allowed us to examine what we had learned from our previous experience and modify our program on the basis of that review. This new initiative was renamed "Comfort Central," recognizing that although no inpatient experience could be entirely "ouchless," we could still pledge to families that we were attentive to pain and would provide the most comfort that we could. Specific changes that were put in place in our model included the acquisition of administrative authority to mandate change; the extension of our program to the laboratory, outpatient clinics, and physician offices; the incorporation of newer, more active educational models; increased emphasis on collaboration with other services; increased visibility of pain-relief efforts; and development of an ongoing quality improvement program that monitors the efficacy of pain-relief initiatives in the institution. The elements of this program may be applicable to other health care systems that desire to develop a more cohesive system-wide approach to pain reduction in those for whom they provide care. Pediatrics 2008;122:S154-S160

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Pain and the neonate

Cited by 5 publications

References 41 publications

Ritual circumcision and risk of autism spectrum disorder in 0- to 9-year-old boys: national cohort study in Denmark

Ritual circumcision and risk of autism spectrum disorder in 0- to 9-year-old boys: national cohort study in Denmark

Nociceptive responses of 3‐day‐old rat pups to IP injection of lithium carbonate

From the Ouchless Place to Comfort Central: The Evolution of a Concept

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