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Children 2016, 3(4), 26; doi:10.3390/children3040026

Beyond Acute Pain: Understanding Chronic Pain in Infancy

1
Department of Psychology, York University, Toronto, ON, M3J 1P3, Canada
2
Department of Psychiatry, The Hospital for Sick Children and the Department of Psychiatry, University of Toronto, Toronto, ON, M5T 1R8, Canada
3
Department of Occupational Science and Occupational Therapy, B.C. Children’s Hospital Research, Vancouver, BC, V5Z 4H4, Canada
4
Women’s Health Research Institute, Vancouver, BC V6H 3N1, Canada
*
Author to whom correspondence should be addressed.
Academic Editor: Lynn Walker
Received: 13 September 2016 / Revised: 31 October 2016 / Accepted: 3 November 2016 / Published: 9 November 2016
(This article belongs to the Special Issue Chronic and Recurrent Pain)
View Full-Text   |   Download PDF [212 KB, uploaded 9 November 2016]

Abstract

This topical review presents the current challenges in defining chronic pain in infants, summarizes evidence from animal and human infant studies regarding the biological processes necessary for chronic pain signaling, and presents observational/experiential evidence from clinical experts. A literature search of four databases (CINAHL, EMBASE, PsycINFO, and MEDLINE) was conducted, along with hand searches of reference lists. Evidence from animal studies suggest that important neurophysiological mechanisms, such as the availability of key neurotransmitters needed for maintenance of chronic pain, may be immature or absent in the developing neonate. In some cases, human infants may be significantly less likely to develop chronic pain. However, evidence also points to altered pain perception, such as allodynia and hyperalgesia, with significant injury. Moreover, clinicians and parents in pediatric intensive care settings describe groups of infants with altered behavioral responses to repeated or prolonged painful stimuli, yet agreement on a working definition of chronic pain in infancy remains elusive. While our understanding of infant chronic pain is still in the rudimentary stages, a promising avenue for the future assessment of chronic pain in infancy would be to develop a clinical tool that uses both neurophysiological approaches and clinical perceptions already presented in the literature. View Full-Text
Keywords: infant; pain; acute; chronic; NICU; persistent pain infant; pain; acute; chronic; NICU; persistent pain
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

DiLorenzo, M.; Pillai Riddell, R.; Holsti, L. Beyond Acute Pain: Understanding Chronic Pain in Infancy. Children 2016, 3, 26.

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