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Helping Infants with Pain During Medical Procedures
Pain Measurement Tool for Babies Less than 1 Year Old

MIPS (Modified Infant Pain Scale)
Scoring: Infants < 28 weeks, score only items 1 through 6
Infants 28-32 weeks, score only items 1 through 7
Infants > 32 weeks, score all items 1 through 10

 

 

 

SCORE

 

 

 

1

0.5

0

1

Sleep during preceding hour

None

Short naps

(5-10 min)

Longer naps (10+ min)

2

Facial expression:
-brow bulge
-open mouth
-chin quiver
-stretch mouth 
 vertical
-stretch mouth
  horizontal
-nasolabial furrow
-eye squeeze

Marked

Less marked

Calm

3

Presence of cry behavior or Quality of cry

Silent cry/ screaming, painful, high pitched

Modulated; can be distracted

No cry

4

Consolability

None after 2 minutes

Quiet after 1 minute of effort

Quiet within 1 minute

5

Motor activity

Thrashing, incessant agitation, still

Moderate agitation

Quiet

6

Flexion of fingers and toes

Pronounced, marked & constant

Less marked; intermittent

Absent

7

Excitability and responsiveness to stimulation

Tremulous, clonic movements.  Moro reflex spontaneous.

Excessive reactivity to any stimulation

Quiet

8

Sucking

(If asleep, score = 0)

Absent or disorganized

Intermittent
(3 or 4); stops with crying

Strong, rhythmic; pacifies

9

Overall tone

Strong hypertonicity

Moderate hypertonicity

Normal

10

Sociability (eye contact) in response to voice, smile, face

(If asleep,

score = 0)

Absent

Difficult to obtain

Easy and prolonged


Source: Buchholz M, et al. 1998.; Modified: Pomietto M & Taquino L 2001
TOTAL SCORE < 28 weeks 28-32 weeks > 32 weeks
0  to  6 0  to  7 0  to  10
comfort pain comfort pain comfort pain

Pain Control Tips for Babies
  • Talk to your baby in a quiet, calm voice.

  • Hold and cuddle your baby. The nurses will show you some ways to hold your baby after surgery.

  • Use pacifiers, music and mobiles to calm your baby.
This handout has been reviewed by clinical staff at Children's Hospital. However, your child's needs are unique. Before you act or rely upon this information, please talk with your child's health care provider.
  • Your health care provider
  • Children's Resource Line 206-987-2500 or 1-866-987-2500
    Toll-Free Washington, Alaska, Montana, Idaho
Compiled and/or developed by the Pain Medicine Program at Children's Hospital and Regional Medical Center.

© 2002 Children's Hospital and Regional Medical Center,
Seattle, Wash., All Rights Reserved.
www.seattlechildrens.org

Pub 1/02
(MW)