Reducing pain and improving brain development for preterm babies

Research Training Fellowship*: Dr Heather Kitt

Each year, around 55,000 babies are born prematurely in the UK.[1-2] Babies born early will experience at least 10 painful procedures every day during their time in neonatal intensive care.[3] Untreated repetitive pain in babies can have lasting effects, including impaired brain development. Dr Heather Kitt at the University of Oxford is investigating whether a combination of gentle touch with skin-to-skin contact can help reduce pain and improve neurodevelopmental outcomes in preterm babies. She hopes to demonstrate that this simple, low-cost intervention can help enhance the lives of these vulnerable babies, leading to its rapid integration into clinical practice.

How are children’s lives affected now?

Every year, more than 39,000 babies born prematurely (before 37 weeks of pregnancy) are admitted to an intensive care unit in the UK.⁴ These tiny babies may stay in hospital for weeks or months, and will require several painful procedures every day as part of their life-sustaining care.

“As well as causing immediate pain and distress, untreated repetitive pain can also have negative effects on babies’ brain development which may harm their long-term wellbeing and life chances,” says Dr Kitt. 

Assessing pain in babies is challenging, and very few methods of pain relief are approved for use. Although commonly used sweet-taste solutions can help alleviate crying, they don’t reduce the actual pain signals reaching the brain. As a result, their effectiveness in reducing the harmful effects of pain on brain development remains uncertain.

How could this research help?

“This research aims to establish whether kangaroo mother care (KMC), which involves skin-to-skin contact, combined with gentle stroking, is an effective way to reduce the pain response of premature babies undergoing an essential blood test,” says Dr Kitt.

The clinical trial will involve 130 preterm babies – with half receiving KMC combined with stroking, and the other half receiving standard care during the procedure. 

“We will measure changes in the babies’ brain activity and other responses, such as heart rate and facial expressions,” says Dr Kitt. “Comparing these responses between the two groups will show if KMC and stroking is more effective than standard care at reducing babies’ acute pain.”

Additionally, 15 babies from each group will undergo a series of clinical assessments at hospital discharge. Dr Kitt will analyse these data to explore whether reducing babies’ pain responses can help to protect their brain cells from the harmful effects of untreated repetitive pain and how this may improve neurodevelopmental outcomes.

References

1. Office for National Statistics, Vital statistics in the UK: births, deaths and marriages 2021 -https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/datasets/vitalstatisticspopulationandhealthreferencetables [website accessed 17 April 2024]
2. National Institute for Health and Care Excellence - Preterm labour and birth final scope April 2013 - http://www.nice.org.uk/guidance/gid-cgwave0660/resources/preterm-labour-and-birth-final-scope2 [website accessed 20 June 2023]
3. Carbajal, R. et al. Epidemiology and treatment of painful procedures in neonates in intensive care units. JAMA 2008; 300(1):60-70.
4. Bliss: Statistics about neonatal care: https://www.bliss.org.uk/research-campaigns/neonatal-care-statistics/statistics-about-neonatal-care [website accessed 02 May 2024]

*Research Training Fellowships

Each year, Action Medical Research awards these prestigious grants to help the brightest and best doctors and scientists develop their career in medical research.

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