Grant: Doctoral Research Award: Canada Graduate Scholarships

Infants hospitalized in Neonatal Intensive Care Units (NICUs) are exposed daily to painful procedures as part of their routine medical care. Due to these infants' inability to report their own pain, it is crucial that health care professionals have accurate pain assessment tools to enact optimal pain management. Unrelieved pain has been shown to alter brain structures and functioning, resulting in poorer long-term physical and psychological outcomes for the 8% of children who are born premature every year. Early in life, due to their developing ability to calm themselves down after distress, infants heavily rely on their caregivers to help regulate from distressing events, like needles. When infants are in pain, they are very sensitive to the way in which their caregivers respond to their distress, cognitively, behaviourally and physiologically, because they are learning from their caregivers how to react and regulate from distress. Caregivers also set the social-emotional context in which infants experience distress. Seminal longitudinal work from our lab showed that caregivers were the most influential factor predicting pain responses from infancy to preschool. By influencing the development of infants' pain responses, caregivers impact the way infant pain will be assessed and consequently managed. The proposed project takes this work and sets out to examine these relationships in Neonatal Intensive Care Units (NICUs). The present study will collect caregiver cognitive, behavioural, and physiological data during a routine blood sampling procedure in NICUs (a heel lance) and examine the relationships with infant brain responses (Electroencephalogram), heart responses (Electrocardiograms) and behaviour (facial activity). By furthering our understanding of how caregivers impact the way infants react and regulate from pain-related distress, this program of research seeks to improve the accuracy of current infant pain assessment practices used in NICUs.