Re: preemie-l RE: Pain

Sheena L Carter (scart01@emory.edu)
Wed, 12 Jun 1996 17:44:56 -0400 (EDT)


On Wed, 12 Jun 1996, Tracy Peters wrote:

> Sara too is not a snuggler.  It's only been in the past 6-8 months
> that she comes to me for any kind of comfort.  Tough when they are
> upset or hurt and as parents we want to console.  Sometimes I feel
> like she thinks, hey I had to get through worse than this on my own
> with no one to hold me so BACK OFF. 


Tracy, Angie, et. al....

	Now, let's not read too much into this!  The OTs tell us that it 
is altered sensitivity to touch that accounts for the resistance to close 
contact, and there is some literature to suggest that very early exposure to 
touch and painful stimuli may be at least partially responsible for this 
phenomena.  In addition to the early association of touch with painful 
stimuli, the development of the nerves themselves may actually be 
influenced by premature exposure to stimuli -- while the 
infant should still be a fetus well-protected in the womb.  (I believe 
Anand has some work pertinent to this & I can ask him for some references 
if people are interested.)  A lot of children with early neurological damage 
who were not born early also have hypo- or hyposensitivity -- as well as some 
perfectly "normal" children, however.  This is still a new field of study.

	I think it is very important to understand and respect your own 
child's particular touch preferences.  One thing a lot of people find is 
that their children prefer deep or firm pressure touch whereas they may 
find light touch extremely uncomfortable.  Some find that their children 
are quite capable of close contact, including hugging and cuddling, if it 
is child-initiated -- allowing them to control the timing and intensity.  
Some parents have told me that their OT has been able to help with 
therapy directly addressing the child's sensation.  Experiment with what 
works best for your child, but understand that it may not be what works 
for others.  And try to find ways to work around those problems you have 
trouble getting past -- maybe accepting that the child doesn't find some 
types of touch pleasurable and finding alternative ways of demonstrating 
your caring feelings.  Try not to take rejection of touch as rejection of 
comforting or of you.

	To my knowledge this has not been found to be related to any 
emotional problems in preemies.  The children I follow (only to age 5 at 
most), as a group, strike me as quite resilient.  While I have no data on 
our kids, I don't see the volume of emotional and behavioral problems I 
would expect given that so many children we serve are also at high 
psychosocial risk for other reasons.  While the "vulnerable child 
syndrome" has received a lot of attention, I would be interested in 
documentation of special strengths in these children.  (Anyone have 
references?)

	Gotta go.  Maybe we can discuss this more later.  I'm sure I'm 
not the only parent typing with one hand tonight, but this is 
probably not how I should feed my baby!

Sheena