The research was funded by the Wellcome Trust and is reported in
the journal eLife.
"Up until recently people didn't think it was possible to
study pain in babies using MRI because, unlike adults, they don't
keep still in the scanner!" said Dr Rebeccah Slater of Oxford
University's Department of Paediatrics, lead author of the report.
"However, as babies that are less than a week old are more
docile than older babies, we found that their parents were able to
get them to fall asleep inside a scanner so that, for the first
time, we could study pain in the infant brain using MRI.
"This is particularly important when it comes to pain:
obviously babies can't tell us about their experience of pain and it
is difficult to infer pain from visual observations. In fact some
people have argued that babies' brains are not developed enough for
them to really 'feel' pain, any reaction being just a reflex - our
study provides the first really strong evidence that this is not the
The researchers say that it is now possible to see pain "happening"
inside the infant brain and it looks a lot like pain in adults.
As recently as the 1980s it was common practice for babies to be
given neuromuscular blocks but no pain relief medication during
surgery. In 2014 a review of neonatal pain management practice in
intensive care highlighted that although such infants experience an
average of 11 painful procedures per day 60% of babies do not
receive any kind of pain medication.
"Thousands of babies across the UK undergo painful
procedures every day but there are often no local pain management
guidelines to help clinicians. Our study suggests that not only do
babies experience pain but they may be more sensitive to it than
adults," said Dr Slater. "We have to think that if we
would provide pain relief for an older child undergoing a procedure
then we should look at giving pain relief to an infant undergoing a
Dr Slater added: "Recent studies in adults have shown that
it is possible to detect a neurological signature of pain using MRI.
In the future we hope to develop similar systems to detect the 'pain
signature' in babies' brains: this could enable us to test different
pain relief treatments and see what would be most effective for this
vulnerable population who can't speak for themselves."
Rachel Edwards, who is 33 and from Oxford, gave permission for
her son Alex to take part in the study. Alex was the first baby to
be placed in the MRI scanner:
Rachel Edwards said: "People know so little about how babies
feel pain, you can tell they are in distress from their reaction and
I was curious about why they react in the way they do.
"Before Alex went in I got to feel all the things he would
feel as part of the study including the pencil-like retracting rod:
it wasn't particularly painful, it was more of a precise feeling of
"It was really reassuring how highly skilled the staff were
and how good they were at calming and handling him.
"I fed him and put him down on this special bean bag that
they suck all the air out of to help keep the babies' heads still.
Then they put on earphones that cut out some of the sound but I
think the noise actually soothed him. He was out for the count, he
didn't wake up during the scanning and seemed really content
The above story is based on materials provided by University of