Pain in the Neonate and Fetus

To the Editor: The superb review article by Anand and Hickey (Nov. 19 issue)¹ provides the scientific basis for what has been intuitively obvious — that infants experience distress in response to noxious stimuli. The weight of evidence that this article provides mandates the same attention to humane care in infants and preverbal children as that traditionally offered to adults. Unfortunately, however, the clinical neglect of pain in children is not limited to infancy. There is now a broad literature that suggests that all children, including those who can speak and request pain relief, typically receive less attention to pain.