Can stroking a baby help it feel less pain?

Gently stroking babies reduces the pain they feel from medical procedures, study finds

Can stroking a baby help it feel less pain?

A gentle touch can soothe an upset baby and even dull its perception of pain, according to a UK study which found light stroking activates touch sensitive nerve endings and suppresses unpleasant sensations.

University of Oxford researchers studying responses to painful early-years procedures such as blood tests found stroking has an “optimal velocity” of 3cm per second, which reduced sensations of pain.

Using an electroencephalogram (EEG), they observed a measurable reduction in electrical impulses in the brain’s pain centres among children who were being lightly stroked but still reacted to the jab.

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“Parents intuitively stroke their babies at this optimal velocity,” said senior author Rebeccah Slater, professor of paediatric science at the University of Oxford.

“We hypothesised that stroking would reduce pain-related brain activity, so we were pleased to see it.

“But we didn’t see a reduction in how they reflex their limbs away from the heel lance. That could mean our intervention is perhaps causing a dissociation between limb movement and brain activity.”

The findings, published in the journal Current Biology, could be incorporated into advice for new parents and for medical staff in neonatal units, to harness stroking’s side-effect free painkilling properties.

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The highly social birds will also remember that person if they come near their nests again, according to researchers from the University of Exeter. In the study, a person unknown to the wild jackdaws approached their nest. At the same time scientists played a recording of a warning call (threatening) or “contact calls” (non-threatening).

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It may also help explain why parenting techniques such as “kangaroo care” – which involves premature babies being held close to the skin – can help improve bonding, the researchers said.

The effect is caused by the activation of a group of sensory nerve cells called c-tactile afferents, which are activated by slow stroking. The effect has been seen in adults but it wasn’t clear if it was learned or instinctive.

“There was evidence to suggest that c-tactile afferents can be activated in babies and that slow, gentle touch can evoke changes in brain activity in infants,” Professor Slater added.

“Previous work has shown that touch may increase parental bonding, decrease stress for both the parents and the baby, and reduce the length of hospital stay.

“Touch seems to have analgesic potential without the risk of side effects.”

Professor Slater, who worked with researchers from Liverpool John Moores University on the study, intends to study the effect on premature babies.


Stroking babies who are in pain may reduce their discomfort

Can stroking a baby help it feel less pain?

Published: 16:00 BST, 17 December 2018 | Updated: 19:46 BST, 17 December 2018

Gently stroking babies helps them cope better with pain, research suggests.

University of Oxford scientists found that when parents instinctively stroke their little ones it triggers nerve fibres in the skin called C-tactile afferents.

Activation of these nerve fibres is thought to reduce activity in the region of the brain associated with pain. 

The researchers claim touch has the 'analgesic potential without the risk of side effects' that can occur from painkillers. 

Gently stroking babies helps them cope better with pain, research suggests (stock)

The study was led by Dr Rebeccah Slater, professor of paediatric neuroscience, and published today in the journal Current Biology. 

The researchers believe their findings demonstrate the effectiveness of infant massage and so-called 'kangaroo care' – holding a premature baby skin-to-skin to help maintain its temperature – to encourage bonding and reduce pain. 

Skin stroking at a speed of 3cm per second has been shown to reduce pain in adults.

However, it was unclear, until now, whether the same effects were also seen in newborns or developed over time. 

To test the theory, the scientists observed the brain activity of 30 full-term newborns before they underwent medically-necessary blood tests. 

Some of the infants were stroked along their shins with a soft brush at a speed of 3cm/s in five-second blocks. Others were stroked at 30cm/s and the remainder not at all. 

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Don't Screen Us Out fears an extra 92 babies with Down's syndrome will be aborted every year when the test becomes publicly available.

Some 90 per cent of foetuses believed to have the condition caused by an extra chromosome are terminated. 

The NHS is set to begin offering NIPT tests next year to women known to have a Down's syndrome risk higher than one in 150. 

Throughout the experiment, all the babies wore electroencephalography (EEG) sensors, which measure tiny bursts of electrical activity in the surface of the brain. 

EEG activity in babies has previously been shown to increase after a blood test but is lower when an intervention, such as painkillers, is given beforehand. 

Results showed activity in the region of the brain associated with pain was reduced by 60 per cent when the babies were stroked – but only when at a speed of 3cm/s. 

This is a similar effect to that seen after topical painkillers are used.

'We hypothesised that stroking would reduce pain-related brain activity, so we were pleased to see it,' Dr Slater said. 

In a second part of the study, 16 babies were stroked at a rate of 3cm/s before undergoing a heel lance – a commonly used method to take blood from a newborn.

These infants had a 40 per cent reduced brain activity in the region linked to pain compared to the 16 control infants who were not stroked. 

Facial expressions were also monitored in the second half of the experiment, which revealed stroking decreased signs of pain – such as furrowed brows and squeezed eyes – by almost 50 per cent.  

In both studies, all the babies jerked away from the site their blood test was being taken from even if they had been stroked.  

'That could mean our intervention is perhaps causing a dissociation between limb movement and brain activity,' Dr Slater added. 

their research, the scientists believe CT afferents could be targeted as a pain-killing technique. 

They add, however, the benefits of stroking reduced over time and therefore further research is required to determine the optimal timing of the intervention.  


Protecting Your Child from Dehydration and Heat Illness

Can stroking a baby help it feel less pain?

With the hot days of summer come summer sports — baseball, tennis, football practice — both in the neighborhood and at camp.

Before you send the kids out to practice — or just for a long day of play in the sun — learn to protect your child against the dangers of dehydration and heat illness. WebMD turned to Albert C.

Hergenroeder, professor of pediatrics at Baylor College of Medicine and chief of the sports medicine clinic at Texas Children's Hospital, for answers to parents' common questions.

1. What puts my child at risk for dehydration?

The same things that put you at risk for dehydration: prolonged exposure to high temperatures, direct sun, and high humidity, without sufficient rest and fluids. The difference is that a child's body surface area makes up a much greater proportion of his overall weight than an adult's, which means children face a much greater risk of dehydration and heat-related illness.

2. What signs of dehydration should we watch for?

Early signs of dehydration include fatigue, thirst, dry lips and tongue, lack of energy, and feeling overheated. But if kids wait to drink until they feel thirsty, they're already dehydrated. Thirst doesn't really kick in until a child has lost 2% of his or her body weight as sweat.

Untreated dehydration can lead to three worse types of heat illness:

  • Heat cramps: Painful cramps of the abdominal muscles, arms, or legs.
  • Heat exhaustion: Dizziness, nausea, vomiting, headaches, weakness, muscle pain, and sometimes unconsciousness.
  • Heat stroke: A temperature of 104 F or higher and severe symptoms, including nausea and vomiting, seizures, disorientation or delirium, lack of sweating, shortness of breath, unconsciousness, and coma.

Both heat exhaustion and heat stroke require immediate care. Heat stroke is a medical emergency that, when untreated, can be deadly. Any child with heat stroke should be rushed to the nearest hospital.

3. What can I do to prevent dehydration in my child?

Make sure they drink cool water early and often. Send your child out to practice or play fully hydrated. Then, during play, make sure your child takes regular breaks to drink fluid, even if your child isn't thirsty.

A good size drink for a child, according to the American Academy of Pediatrics, is 5 ounces of cold tap water for a child weighing 88 pounds, and nine ounces for a teen weighing 132 pounds.

One ounce is about two kid-size gulps.

Get them acclimatized before summer practice. “If you're going to send your kid off to tennis camp, they shouldn't be sitting around doing nothing in May and then going out to play tennis eight hours a day in June,” says Hergenroeder.

“They should be outdoors jogging, riding a bike, and otherwise slowly building up their fitness and ability to handle the heat.

” The fitter children are, the sooner their bodies will start to sweat after beginning to exercise — and that's a good thing!

Know that dehydration is cumulative. If your child is 1% or 2% dehydrated on Monday and doesn't drink enough fluids that night, then gets 1% or 2% dehydrated again on Tuesday, that means your child is 3% or 4% dehydrated at the end of the day.

“They may be gradually developing a problem, but it won't show up for several days,” says Hergenroeder. “You should always monitor your child's hydration.” One way to do this: weigh your child before and after practice.

If his weight drops, he's not drinking enough during his workout.

A simple rule of thumb: if your child's urine is dark in color, rather than clear or light yellow, he or she may be becoming dehydrated.

4. If my child develops heat illness, what can I do to treat it?

The first thing you should do with any heat illness is get the child the sun into a cool, comfortable place. Have the child start drinking plenty of cool fluids. The child should also take off any excess layers of clothing or bulky equipment. You can put cool, wet cloths on overheated skin. In cases of heat cramps, gentle stretches to the affected muscle should relieve the pain.

Kids with heat exhaustion should be treated in the same way but should not be allowed back on the field the same day. Monitor your child even more carefully, Hergenroeder says. If your child doesn't improve, or can't take fluids, see a doctor.

Heat stroke is always an emergency and requires immediate medical attention.

5. Are some children more prone to dehydration or heat illness than others?

Yes, says Hergenroeder. One of the biggest risk factors: a previous episode of dehydration or heat illness. Other factors that can put your child at greater risk for heat illness include obesity, recent illness (especially if the child has been vomiting or has had diarrhea), and use of antihistamines or diuretics.

Lack of acclimatization to hot weather and exercising beyond their level of fitness can also lead to heat illness in young athletes.

“If a young player isn't in shape and tries to go out and do things quickly to 'make the team' — or goes to summer practice or summer camp and hasn't been used to that kind of heat and humidity and duration of exercise — that sets them up for dehydration and heat illness,” Hergenroeder says.

6. Is it ever too hot for my child to practice or play sports?

A growing number of athletic programs suggest that it is sometimes too hot to practice. In fact, many are restricting outdoor practice when the National Weather Service's heat index rises above a certain temperature. The heat index, measured in degrees Fahrenheit, is an accurate measure of how hot it really feels when the relative humidity is added to the actual temperature.

The National Athletic Trainers' Association (NATA) offers information and guidelines for parents and coaches on its website.

SOURCES: Albert C. Hergenroeder, professor of pediatrics, Baylor College of Medicine; chief, the sports medicine clinic, Texas Children's Hospital.

National Athletic Trainers' Association web site. American Academy of Pediatrics press release: “Kids Should Not Consume Energy Drinks, and Rarely Need Sports Drinks, Says AAP.”

© 2019 WebMD, LLC. All rights reserved.


Gently stroking babies before medical procedures may reduce pain processing

Can stroking a baby help it feel less pain?

Researchers found that gently stroking a baby seems to reduce activity in the infant brain associated with painful experiences. Their results, appearing December 17 in the journal Current Biology, suggest that lightly brushing an infant at a certain speed — of approximately 3 centimeters per second — could provide effective pain relief before clinically necessary medical procedures.

“Parents intuitively stroke their babies at this optimal velocity,” says senior author Rebeccah Slater, professor of pediatric science at the University of Oxford, who worked alongside collaborators from Liverpool John Moores University. “If we can better understand the neurobiological underpinnings of techniques infant massage, we can improve the advice we give to parents on how to comfort their babies.”

Slater and her team measured newborns' pain responses to medically necessary blood tests by observing their behavior and detecting their brain activity using electroencephalography (EEG), a technique that measures tiny bursts of electrical activity from the surface of the brain. For half of the babies, a scientist on Slater's team stroked their skin gently with a soft brush right before the blood test.

Slater's previous work showed that EEG activity increases in the infant brain immediately after a blood test.

This pattern of pain-related activity can be lowered by interventions, such as the application of a local anesthetic prior to the procedure.

In her most recent experiment, she found that the babies who received light stroking touch showed lower pain-related EEG activity. However, the babies still reflexed their limbs away from the stimulus.

“We hypothesized that stroking would reduce pain-related brain activity, so we were pleased to see it. But we didn't see a reduction in how they reflex their limbs away from the heel lance,” says Slater. “That could mean our intervention is perhaps causing a dissociation between limb movement and brain activity.”

The optimal pain-reducing stroking speed of approximately 3 centimeters per second is the same frequency that activates a class of sensory neurons in the skin called C-tactile afferents, which have been previously been shown to reduce pain in adults. Up until now, it was unclear whether this sensory response occurred in newborns or developed over time.

“There was evidence to suggest that C-tactile afferents can be activated in babies and that slow, gentle touch can evoke changes in brain activity in infants,” says Slater.

Slater says that the pain-reducing power of stroking appears to be clinically useful, and it could explain anecdotal evidence of the soothing power of touch-based interventions such as infant massage and kangaroo care — the practice of holding premature babies against the skin to encourage parent-infant bonding and possibly reduce pain. Slater and her group plan to repeat their experiment in premature babies, whose sensory pathways are still developing.

“Previous work has shown that touch may increase parental bonding, decrease stress for both the parents and the baby, and reduce the length of hospital stay,” says Slater. “Touch seems to have analgesic potential without the risk of side effects.”

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Materials provided by Cell Press. Note: Content may be edited for style and length.

Journal Reference:

  1. Deniz Gursul, Sezgi Goksan, Caroline Hartley, Gabriela Schmidt Mellado, Fiona Moultrie, Amy Hoskin, Eleri Adams, Gareth Hathway, Susannah Walker, Francis McGlone, Rebeccah Slater. Stroking modulates noxious-evoked brain activity in human infants. Current Biology, 2018; 28 (24): R1380 DOI: 10.1016/j.cub.2018.11.014


What parents need to know about pain in newborns – Harvard Health Blog – Harvard Health Publishing

Can stroking a baby help it feel less pain?

Just because newborn babies can’t tell you they feel pain doesn’t mean they don’t feel pain. They do. And parents can help.

We tend to think that newborns are too little to really experience pain, and that if they do experience it, they soon forget it. However, research has shown that, indeed, babies do experience pain — and that repeated painful experiences in the newborn period can lead to both short- and long-term problems with development, emotions, and responses to stress.

This is particularly a problem for babies who need many medical procedures after they are born, such as premature babies, babies with certain birth defects, and those who have birth complications or get sick shortly after birth. But even perfectly healthy babies may have some painful procedures, such as heel sticks for newborn screening tests, immunizations, or circumcisions.

That’s why the American Academy of Pediatrics (AAP) recently released an updated policy statement on the prevention and management of procedural pain in newborns: to lessen the pain newborns experience. While the policy statement is written for health care providers, it’s important for the parents of newborns to be aware of it too.

We certainly need to avoid doing painful procedures in the first place. The policy statement does say that we should be very thoughtful and careful when it comes to choosing to do painful things to babies. But some of the painful things we do are either necessary or very helpful to the health of babies now and in the future.

Luckily, there are things health care providers — and parents — can do.

It turns out that even something as simple as holding a baby during a procedure can make a difference. Swaddling the baby, or just holding him or her in a bent position with the arms tight against the body, has been shown to lessen pain.

So has breastfeeding during the procedure — or giving expressed breast milk. It also can help to simply look at and gently talk to the baby, while stroking the face or back.

If a child is very sick or the procedure is complicated, it may not be practical to hold, nurse, or stroke and talk to a baby during a procedure, but it certainly could be done during a heel stick or immunization.

Another simple way to help is by giving babies sucrose, or sugar. It’s not fully clear how sucrose helps, but it does (glucose, which is similar to sucrose, can work too). It may be that the sweet taste activates natural pain-killing chemicals in the body.

It’s best to give it about 2 minutes before the procedure, and the effects last about 4 minutes; for longer procedures such as circumcision, a few doses may be needed.

If you talk to and massage the baby along with giving the sucrose, the effects may be even stronger.

For more painful procedures, there are medications (such as opioids, morphine) that can be used. These medications have side effects, and must be used very carefully, but the AAP urges doctors to always think about using them.

So, parents, if you are told that your baby is going to have a procedure, ask questions. Ask if the procedure is necessary. If it is, ask what can be done to prevent or lessen pain. Ask if you can hold, or caress and talk to, your baby. Ask about using sucrose or glucose. Ask if there are other medications that might help.

Hopefully you won’t need to; hopefully, your doctor or nurse will suggest something before you even have a chance to say anything. But if they don’t, do what your baby can’t do: speak up.



Can stroking a baby help it feel less pain?

A stroke (sometimes called a “brain attack”) happens when blood flow to the brain stops, even for a second.

Blood carries oxygen and other important substances to the body's cells and organs, including the brain. In an ischemic (ih-SKEE-mik) stroke, these substances can't get to the brain and brain cells die. This can permanently damage the brain and make a person's body stop working as it should.

In a hemorrhagic (heh-meh-RA-jik) stroke, a blood vessel in the brain breaks, flooding the brain with blood and damaging brain cells.

Who Gets Strokes?

Many of us think that strokes only happen in adults, especially older adults. But kids can have strokes too. Although they're less common in kids, strokes can happen in children of all ages, even those who haven't been born yet.

Strokes in children most often happen within the first month after birth. These are sometimes called perinatal (or neonatal) strokes. Most perinatal (pair-ih-NAY-tul) strokes happen during delivery or right after delivery when the baby doesn't get enough oxygen while traveling through the birth canal.

Strokes also can affect older kids. But most of these are caused by another condition that stops the flow of blood to the brain or causes bleeding in the brain.

What Causes Strokes?

Finding the cause of a stroke in a child can be hard. Strokes in adults often happen because of high blood pressure, diabetes, or atherosclerosis. The risk factors for stroke in children are more varied.

Ischemic strokes are the most common type in children. They're usually related to:

  • lack of oxygen during birth
  • a heart defect the baby is born with
  • blood disorders such as sickle cell disease, which destroys blood cells and blocks blood vessels
  • injury to an artery (a blood vessel that brings oxygen) in the brain
  • dehydration
  • genetic disorders Moyamoya, a rare disease that affects arteries in the brain
  • an infection, such as meningitis or chickenpox

Some problems that affect a mother during pregnancy can cause a baby to have an ischemic stroke before or after birth. These include:

  • preeclampsia (high blood pressure during pregnancy that can cause swelling in the hands, feet, and legs)
  • premature rupture of the membranes (when a woman's water breaks more than 24 hours before labor starts)
  • diabetes
  • infections
  • drug abuse
  • placenta problems that decrease the baby's oxygen supply, such as placental abruption

Hemorrhagic strokes can be caused by:

  • a head injury that causes a broken blood vessel
  • arteriovenous malformation, a condition in which the blood vessels in the brain don't connect properly
  • an aneurysm (weakness in an artery wall)
  • diseases that affect blood clotting, such as hemophilia

What Are the Signs & Symptoms of a Stroke?

Signs of a stroke in older children are often similar to signs in adults, such as:

  • sudden weakness
  • slurred speech
  • blurred vision

Babies who have a perinatal stroke often don't show any signs of it until months or years later. In some cases, they develop normally, but at a much slower pace than other kids. They also might tend to use one hand more than the other.

Children whose perinatal strokes cause more brain injury might have seizures. The severity of seizures can vary, ranging from the child simply staring into space to violent shaking of an arm or leg.

Signs of a strokein infants:

  • seizures in one area of the body, such as an arm or a leg
  • problems eating
  • trouble breathing or pauses in breathing (apnea)
  • early preference for use of one hand over the other
  • developmental delays, such as rolling over and crawling later than usual

A seizure may be the first sign that an older child or adolescent has had a stroke. These children might also have sudden paralysis (inability to move) or weakness on one side of the body, depending on the area of the brain that's affected and the amount of damage the stroke causes. More ly, a parent first notices changes in the child's behavior, concentration, memory, or speech.

Common signs of strokein kids and teens:

  • seizures
  • headaches, possibly with vomiting
  • sudden paralysis or weakness on one side of the body
  • language or speech delays or changes, such as slurring
  • trouble swallowing
  • vision problems, such as blurred or double vision
  • tendency to not use one of the arms or hands
  • tightness or restricted movement in the arms and legs
  • trouble with schoolwork
  • memory loss
  • sudden mood or behavioral changes

If your child has any of these symptoms, see a doctor right away or call 911. Kids who are actively having a stroke can be given medicine that might reduce the severity of the stroke and the brain damage it can cause.

How Is a Stroke Diagnosed?

Perinatal and early childhood strokes can be hard to diagnose, especially if a child has no clear signs or symptoms. In some cases, a stroke is found to be causing seizures or developmental delays only after many other conditions have been ruled out.

If stroke is suspected, a doctor will probably want the child to have one or more of these tests:

  • blood tests
  • magnetic resonance imaging (MRI): a safe and painless test that uses magnets, radio waves, and computer technology to produce very good pictures of internal body parts, such as the brain
  • magnetic resonance angiography (MRA): an MRI of specific arteries
  • magnetic resonance venography (MRV): an MRI of specific veins
  • computed tomography scan (CT or CAT scan): a quick and painless test that produces pictures of bones and other body parts using X-rays and a computer
  • computed tomography angiography (CTA): an X-ray of specific arteries
  • cranial ultrasound: high-frequency sound waves that bounce off organs and create a picture of the brain
  • lumbar puncture (spinal tap)

How Are Strokes Treated?

Treatment for a stroke is :

  • the child's age
  • what signs and symptoms the child has
  • which area of the brain is affected
  • how much brain tissue was damaged
  • whether an ongoing condition caused the stroke

Many different treatments are possible. For example:

  • A child who has seizures may need anti-seizure medicines.
  • A child with a heart defect might need blood-thinning medicine.

For most kids, treatment also involves:

  • physical medicine and rehabilitation, or physiatry (fiz-ee-A-tree). Physiatrists (fiz-ee-A-trists) are doctors who use many different types of therapy to help children recover from a stroke. They work to enhance and restore functional ability and quality of life in people who have medical conditions that affect the brain, spinal cord, nerves, bones, joints, ligaments, muscles, and tendons.

What Problems Can Happen?

Brain damage from a stroke can cause a number of problems, some of which can be lasting, such as:

  • cerebral palsy
  • cognitive and learning problems
  • paralysis or weakness on one side
  • communication problems
  • vision problems
  • psychological problems

Kids who've had a stroke will see doctors who specialize in helping people cope with these problems. These specialists might include:

  • occupational therapists
  • physical therapists
  • speech therapists

A physiatrist might oversee the child's care.

What Else Should I Know?

At this time, there's no treatment that can fix brain cells that have died. But undamaged brain cells can learn to do the jobs of cells that have died, especially in young people.

In many cases after a stroke, kids can learn to use their arms and legs and speak again through brain retraining. This process is usually slow and difficult. But kids have an edge over adults because their young brains are still developing. Most kids who have had strokes can interact normally and be active members of their communities.

How Can I Help My Child?

If your child had a stroke, you aren't facing his or her rehabilitation and future care alone. The doctors and therapists who will work with your child are there to support the whole family. Don't hesitate to ask questions about your child's condition or treatment or to ask for help when you need it.

Also look for support groups for parents of kids who have had strokes, such as:

The input and support from other parents facing the same challenges can help you find the strength you need to help your child get the best care possible.

Reviewed by: Marcella A. Escoto, DO

Date reviewed: December 2018