Do babies feel pain?

Sometimes a baby is born with portions of their intestines exposed (e.g. gastroschisis) and we had one such baby in the NICU who required daily tightening of the silo (a clear wrap around the intestines to protect it from infection and maintain moisture) in order to stretch the abdomen so that it can accept the intestinal contents when it finally gets the corrective surgery.

While you would think it is a painful process (certainly appears that way - squishing the intestines into the belly of the infant), it's probably not all that painful. The intestines lack the typical pain nerve fibers we find in our skin, for example, and really only respond to stretch or burn. I guess in theory you can slice up the intestines without the patient feeling any pain, but I'm not sure if it's been _proven_ to be true (other than the histology demonstrating the lack of certain pain fibers).

Regardless, the nurses in the NICU tend to be very protective of their charges (and perhaps rightly so), and they do insist on some sort of pain management before tightening the silo. As these are rather sick babies in general, you had to get the timing just right to ensure that they are pre-medicated prior to the arrival of the resident/attending so that the tightening can take place without much discomfort on the baby's part.

But this can come at a cost, too - these scheduling requirements can delay the process signficiantly, and until the operation is complete the baby remains in danger of popping out the silo and exposing the intestines again (and I've seen this happen once).

What am I getting at, exactly? Well - in short, there is a (potential) cost to pain management, and I'm not sure if the desire to avoid pain in the neonate is blinding us to the risks we are taking.

Pain should be avoided - true, but if I learned anything from anesthesia, it's more to relax the patient than to avoid pain per se. Given medications that induce amnesia, most patients will not recall the painful experiences (although I guess it could still be argued as a form of torture).

Do babies remember pain? Is it "torture" to inflict pain on a baby? Do babies even truly "feel" pain as we do (and by this I mean perceive it, not simply react as in crying)? We don't really know many of these answers, yet we project ourselves into the baby and try to spare it from all the pain we can - sometimes without really recognizing the new dangers we have now placed the baby into by our desire to avoid pain.