Parenting pain away with combined parental live lullaby singing, skin-to-skin care and breastfeeding, is a recent and currently ongoing movement across NICUs and healthcare globally, but few NICUs have fully embraced parent inclusion. Parent-provided pain management is more than simply a humane and compassionate concept. The inclusion of parents has been scientifically proven to be one of the most effective ways to reduce pain associated with repeated painful procedures in early life and parents report a desire to participate. Cutting-edge results are presented from the ongoing interdisciplinary, multicenter, mixed methods project “Parents as pain management in Swedish neonatal care (SWEpap)”, an internationally pioneering study incorporating parents’ lullaby singing. In SWEpap, music therapy and nursing research mobilizes parents’ pain alleviating resources striving to close the knowledge-to-practice gap and facilitate change of clinical practice. The project’s qualitative results show that the parents’ live singing facilitated parental participation and parent-infant closeness helping the family calm down during the procedure.

As part of their life-saving care, infants admitted to the neonatal intensive care unit (NICU) are often exposed to repeated invasive procedures. Previously, parents have identified that witnessing their infant in pain is one of the most stress-inducing experiences in the NICU. This stress may persist well-beyond the NICU, and the memories of their infant in pain may significantly impact their mental health. Neonatal pain-related distress is equally impactful to the infant, as numerous studies have demonstrated a relationship between repeated invasive procedures early in life and poorer cognitive and behavioral outcomes in NICU-born children. Recently, we demonstrated that positive parental interactions can help to mitigate the negative effects of neonatal pain on infant neurodevelopment. However, these positive interactions are undermined by chronic parental stress. Therefore, to best support infants and their parents it is important that infant pain be appropriately managed in the NICU. Parents also need to be involved and supported in the neonatal care of their infant. Altogether, neonatal pain management can lead to changing neonatal and parental trajectories and contribute to the optimization of infant outcomes.

Pain is experienced by all people regardless of age, gender or ethnicity, and access to pain treatment is a basic human right. Nevertheless, measuring and treating pain in newborn infants is difficult. This is because babies cannot tell us when they are in pain and cannot tell us whether pain-relieving medications are working. So, in clinical practice we often rely on behaviours – such as changes in facial expression, when we attempt to measure and treat pain. However, sometimes a newborn child who is hungry, tired, irritable or in pain shows similar facial expression and body movements – making it difficult to decide how best to treat them. Since pain is an experience that occurs in the brain, one approach that can help us better understand infant pain is to look at patterns of brain activity. In this talk I will tell you how measuring pain-related brain activity in infants can help us find new ways to measure and treat pain in young children, and how pain-related brain additivity changes in early development.