Pain Management by OTs

Hi Everyone!

Occupational therapists (OTs) play an important role in managing pain in infants in the Neonatal Intensive Care Unit (NICU). Babies are under a lot of stress when in the NICU. They are under bright lights and hear loud sounds. These are all things that are new from the womb, and on top of that, they are premature and do not have developed sensory integration patterns yet. Sadly, painful procedures are performed on infants in the NICU often like blood tests. Pain experienced this early in life has the potential to change the development of the brain and lead to unwanted long-term outcomes.

Therefore, it is important for an occupational therapist to prevent NICU pain and stress triggers to promote the best neurodevelopment possible for the baby. Occupational therapists evaluate the environment that influences’ the babies like light and sound. They try to reduce the light directly over the baby in the isolette. Also, they watch the baby’s reactions to be able to tell what causes them stress since they can’t communicate with us. Premature infants do experience pain differently than other infants due to immature brain and muscles.  

In order to give accurate pain evaluations, an assessment called Behavioral Indicators of Infant Pain (BIIP) helps “evaluates the presence or absence of five anatomically defined facial processes, two hand reasons, and sleep/wake states” (Holsti, 2011, p. 9). Babies in the NICU cannot take normal medication due to significant side effects. Hence, occupational therapist promote non-pharmacological treatment to activate innate pain moderating systems. By encouraging multiple activities at once, it reduces pain. Sucking a pacifier stimulates hormones such as serotonin, which reduces pain and by holding the baby at the same time or feeding. Positioning can also be crucial to pain control. Trunk tucking or the action of flexing the babies arms, legs, and head into close proximity gives the baby support, comfort, and control stress. OTs also educate parents to notice when their baby is in distress during certain activities, so that the OTs can work with them to minimize it in order for the baby to have the best neurodevelopment in and out of the NICU.

Thanks for reading,

Kayla

 

Works Cited:

Holsti, L. (2011). Occupational Therapists Play an Important Role in Managing Pain in Infants in Neonatal Intensive Care Unit. Occupational Therapy Now, 14.5, 8-9.