Table 1

Modified Pain Assessment Tool (mPAT)

The mPAT
	0	1	2
Posture/tone	Normal Some flexion	Digits widespread Trunk rigid Limbs drawn out Shoulders raised off bed	Fists clenched Trunk guarded Limbs drawn to midline Head and shoulders resist posturing
Cry	No	Consolable Can be settled	When disturbed Doesn't settle after handling Loud Whimpering Whining
Sleep pattern	Relaxed	Easily woken	Agitated or withdrawn Wakes with startle Restless Squirming No clear sleep/wake pattern Eye aversion 'shut out'
Expression	Relaxed Normal	Frown Shallow furrows Eyes lightly closed	Grimace Deep furrows Eyes tightly closed Pupils dilated
Colour	Pink well perfused	Occasionally mottled or pale	PaleIduskyIflushed Palmar sweating
Respirations	Normal baseline rate	Tachypnoea—at rest	Apnoea—at rest or with handling
Heart rate	Normal baseline rate	Tachycardia—at rest	Fluctuating—spontaneous or at Rest
Oxygen saturation	Normal	Fleeting desaturation	Desaturation with or without handling
Blood pressure	Normal		Hypotension/hypertension at rest
Nurse's perception	No pain perceived	I think the baby is in pain only with handling	I think the baby is in pain