The extent that your baby experiences pain and discomfort will vary depending on the procedure they undergo. Below are examples of procedures and the typical pain experienced during them:
- Discomfort at varying intensity: physical examinations, hip checks, replacing a nasogastric tube, etc.
- Intense, short-term acute pain which generally eases after the completion of the task: procedures involving skin breakages such as the insertion of intravenous lines or taking blood samples.
- More intense pain: invasive procedures such as chest tube insertion or pain following surgery.
- Chronic (prolonged) pain at varying intensity: necrotising entercolitis (NEC) or meningitis. This pain generally requires a high level of medication which is prescribed at regular intervals.
Whatever the procedure, the medical team will aim to minimise the level of pain experienced by your baby.
Throughout all routine procedures, you may be asked to assist in comfort holding or to continue to breastfeed or start kangaroo care. Sometimes, non-nutritive sucking on a soother/pacifier which has been dipped in breast milk is enough to settle some babies. Other times, a soother/dummy dipped in sucrose (sugar) is required. Alternatively, 0.2 millilitre (ml) of sucrose is given directly into the baby’s mouth. Sucrose is effective for reducing procedural pain from single events such as a heel prick or venepuncture and intramuscular injection in both preterm and term babies. No side effects have been recorded from the administration of sucrose 
Breastfeeding, or oral administration of breast milk, is the preferred pain relief (analgesic) approach as it appears to be as effective as sucrose for analgesic purposes. Breast milk also has the added benefitofn supporting the baby’s development. However, breastfeeding or oral administration of breast milk is not possible when the baby is intubated or for a very preterm baby undergoing clinical procedures. In these cases, sucrose becomes more important.
If your baby undergoes more invasive or painful procedures, they will be given paracetamol or other appropriate pain relief (analgesic). The dose will be based on your baby’s weight and the administration approach, i.e. administered on one occasion (‘once-off’) or every 4 – 6 hour as required. Local anaesthetics, given through a small injection under the skin, and topical gels may also be used, depending on the procedure. If your baby undergoes procedures that cause extreme discomfort or require them to stay in the same position for a long period of time, sedative and/or opioid drugs may be used.
These drugs will be administered orally, intravenously, or intramuscularly. Administration will either be a ‘once-off’ or through an infusion pump, i.e. delivering the drug slowly over a specified length of time. If deep sedation is required, a combination of sedative and opioids drugs may be used. Alternatively, a general anaesthetic can be used for deep sedation.