Measuring pain in newborns is inherently complicated when juxtaposed with adults. Variations in infants’ developmental stages often result in either overestimating or underestimating pain experiences, with potentially grave consequences. Such misjudgments can lead to overtreatment through unnecessary sedation or, conversely, inadequate pain relief, each carrying its own set of safety risks. Notably, premature infants present an even more intricate challenge; their immature physiological and behavioral responses result in a limited capacity to exhibit definitive pain behaviors, complicating assessment efforts further.

There are intrinsic challenges faced when relying on clinical rating scales as proxies for actual pain measurement. Given the pervasive uncertainty illuminated by this review, Soll urges clinical staff to exercise caution by not becoming overly reliant on the current rating scales that are in circulation; instead, he advocates for a more proactive approach aimed at minimizing painful procedures altogether for this delicate patient population, prioritizing their overall safety and comfort.

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