Working together to protect babies’ developing brains from repeated pain
How often have we been asked by a parent about a procedure, ‘Does it hurt?’. If we had a tool that showed how painful procedures might be for babies and how parents could help, it might ease pain management. An opportunity to bridge this gap came from our systematic review which estimated and ranked babies’ pain from 15 common hospital procedures (Laudiano-Dray et al., 2020). The key findings were that all procedures crossed the 30% threshold for pain relief.
I work as a nurse at University College London’s Infant Pain and Somatosensory Imaging (IPSI) research group, which is dedicated to understanding pain in babies. We translated the estimated procedural pain ranking into an accessible, co-designed communication tool to help neonatal staff and parents work together to reduce babies’ pain. The tool has three key messages: i) Prepare, use our estimated pain ranking to inform timing and management of procedures in collaboration with a second person, ideally the parent, ii) Support, the parent or second person to combine pain-relieving interventions to maximise comfort before, during, and after procedures, iii) Protect babies’ developing brains from the short- and long-term effects of repeated pain by providing pain management consistently.
We achieved our goal to disseminate the tool to pain champions who would introduce the tool to their local units, reaching 119 healthcare professionals and allied healthcare professionals from 73 neonatal units across the UK and Ireland. For this, we would like to say a huge ‘Thank you!’ to the Neonatal Nurses’ Association (NNA) for being one of our earliest champions in advancing family-integrated pain management.
Engaging with policymakers at the earliest stage was crucial in successful dissemination of the tool. With funding provided by the Medical Research Foundation, our research group identified the NNA to be a powerful influence in raising awareness and changing policy. The NNA’s endorsement of the tool after a review of our proposed project was a vital step in reaching our target audience. The NNA helped launch the tool through a webinar enabling us to expand a network of pain champions including nurses, doctors, allied health professionals, and parents, and sharing of the webinar with colleagues as a pain management teaching resource. I received support to represent the NNA in a working group that developed the British Association of Perinatal Medicine (2025) framework for neonatal pain management. This enabled me to contribute to the framework, including the tool and an infographic describing the central nervous system’s signs of pain and stress.
Our next step is to deliver the tool in multiple languages to make pain management equitable for parents. We continually need nurses, doctors, and allied health professionals to be pain champions and bring the tool to their local neonatal units. If you would like to find out more about how you can take part, then watch the webinar and view the supporting materials in the NNA endorsement page. Thank you!
Maria Pureza Laudiano-Dray
Research Nurse, UCL
References:
British Association of Perinatal Medicine. (2025). Management of neonatal pain: A BAPM framework for practice. November 2025. https://hubble-live-assets.s3.eu-west-1.amazonaws.com/bapm/file_asset/file/3857/Management_of_Neonatal_Pain_Nov_25.pdf
Laudiano-Dray, M. P., Pillai Riddell, R., Jones, L., Iyer, R., Whitehead, K., Fitzgerald, M., Fabrizi, L., & Meek, J. (2020). Quantification of neonatal procedural pain severity: a platform for estimating total pain burden in individual infants. Pain, 161(6), 1270–1277. https://doi.org/10.1097/j.pain.0000000000001814





I’m Lora Alexander, one of the Quality Improvement coaches in a busy Level 3 NICU. QI is all about understanding problems, thinking of solutions, implementing ideas and analysing the results.
My name is Adedoyin Yissau, also known as Dee. I am the Education and Workforce Lead for the London Operational Delivery Network. I came into post as a Network Educator in 2019 and have since developed nursing education region wide, with the current focus on developing a nursing career pathway for London.
Neonatal Network Nurse Educator
My name is Dr. Julia Petty, and I am a nurse lecturer specialising in children’s nursing with a particular interest in neonatal care. My nursing career in paediatric and neonatal clinical nursing practice began after a BSc Hons degree in Psychology at Warwick University, when I moved to Great Ormond Street Hospital, London. Here, I trained in children’s and adult nursing before working there for many years in children’s and neonatal surgical care. I then gained my neonatal nursing qualification at St George’s NHS Trust London and worked at the Whittington NHS Trust NICU before moving back to Great Ormond Street for a senior education role on NICU where I worked until 2001. I then worked as Senior Lecturer at City University, London for 12 years leading the neonatal nursing education portfolio. I studied for a MSc, a PGCE and MA in academic practice during this time, In 2013, I moved to the University of Hertfordshire where my role is Associate Professor (learning and teaching) and Senior lecturer child nursing. I teach on the BSc Hons nursing and master’s degree programmes including leadership of modules, face-to-face/online teaching, assessing and supervision of students at all levels up to doctorate level. I am also research active and have completed a Doctorate in Education. As a nurse, educator and post-doctorate researcher, my interests focus on parents’ premature birth experiences, supporting parents in the transition home from NICU, exploring communication needs of neonates and their carers and studying the educational value of digital storytelling. This combination and variety of roles enriches my working life and brings together my experience as a child / neonatal nurse, educator and researcher. My role and related activities enable me to engage in both education and research while supporting students on their nursing career and education pathway, which is a privilege to be part of.
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Hello, my name is Kim Edwards, and I am a Neonatal Nurse. I am currently the Lead Nurse and Workforce, Education Lead for the Thames Valley and Wessex Neonatal Operational Delivery Network (ODN)
Hello, my name is Jean and I am a registered children’s nurse with 27 years experience. I qualified with a DipHE after struggling academically due to dyslexia. Over my career I have worked mainly in PICU, NICU and children’s cardiac critical care. I am dual qualified in speciality (QIS) for both Neonatal and Paediatrics. The QIS program is a post graduate modular course completed at level 6/7. To be considered QIS you must successfully complete 4 separate modules, each have an academic and practical component. Only on completion of the QIS course can you apply for a band 6 role. In addition to the above qualifications it is expected you would have several years proven experience in speciality at Band 6 and 7 prior to applying for a Matron’s role.
My name is Lisa Baker, I’m a Ward Manager on a Level 2 Special Care Baby Unit in South Wales and I’ve been in this role since 2020.
Hello, my name is Wesell, and I am currently a trainee Advanced Neonatal Nurse Practitioner (ANNP) at Great Western Hospital, which is a Local Neonatal Unit (LNU). Prior to this, I gained substantial experience in a tertiary neonatal unit where I completed my QIS course at master’s level. This course, alongside my role as a senior nurse, provided me with the expertise required to develop my career further in neonatal care.
My name is Hannah Wells, and I am a Neonatal Surgical Clinical Nurse Specialist (CNS).
Hi, I am Amanda and work as the Neonatal Infant Feeding Coordinator for a NICU and a SCBU within one service. While the role is not standardised, many neonatal units now have dedicated posts.
Hello, my name is Daniela Machado, and I am proud to be a Developmental Care Specialist/Lead Nurse and a sister/charge nurse, working across two different trusts. I am originally from Porto, Portugal, and have spent 14 years building my nursing career in the UK. My role involves applying and advancing neuroprotective/developmental care practices for our preterm and neonatal patients/families.
Hello! I am Renjita Raju , a Neonatal Junior Sister working in London. After completing my BSc nursing degree in India, I moved to UK, and completed NMC OSCE to get registered and QIS course to become specialised in neonatal care. I recently qualified as an NLS instructor with the support from NNA scholarship programme. My role involves caring for premature and critically ill newborns, ensuring their safety and health with a highly collaborative multidisciplinary team. I also teach in NLS courses as an instructor following my passion in neonatal resuscitation. I love witnessing infants grow stronger each day and supporting their families through this journey. I’m grateful for the opportunity to provide meaningful compassionate care to the tiniest, most vulnerable patients. 