Too Small to Suffer? A call for standardized neonatal pain protocols in southeast Asian NICUs

Abstract

Neonatal pain remains grossly under-recognized in NICUs across South Asia. Recent evidence notes that neonates often endure repeated painful procedures without proper analgesia; a problem “underrecognized and undertreated” in many developing countries.¹ International consensus guidelines emphasize that neonates are also sensitive to pain and mandate routine assessment and thereby emphasizes on avoidance of unnecessary stimuli to neonates. However, in current practices most NICUs lack standardized protocols of both pain assessment and pain management. In West Oromia, a study demon-strated that 62.6% of nurses exhibited adequate knowledge, while only 16.3% demonstrated good practice in neonatal pain management², similarly Jember Et al. found that only 48% of healthcare professionals possessed adequate knowledge but only a fraction of mere 5.7% demonstrated good practices in neonatal pain management.¹