Identification of pain in neonates: the adults’ visual perception of neonatal facial features

Objective To verify the visual attention of adults when assessing neonatal pain. Study design 143 adults (59% health professionals) evaluated 20 pictures (2 pictures of 10 neonates’ faces: at rest; during a painful procedure). Tobii-TX300 tracked the participants’ eyes movement. For each picture, adults scored pain intensity (0 = no pain; 10 = maximum). Latent classes analysis was applied by cognitive diagnosis models—GDINA with two attributes (knowledge of pain presence/absence). Variables associated with belonging to the class of adults that correctly identified pictures of newborns with/without pain were identified by logistic regression. Results To identify neonatal pain, adults look at the mouth, eyes, and forehead in facial pictures. The latent class analysis identified four classes of adults: those that identify painful/painless neonates (YY-Class; n = 80); only painful neonates ( n = 28); only painless neonates ( n = 34) and none ( n = 1). Being a health professional (OR: 2.29; 95% CI: 1.16–4.51), and each look at the nasolabial furrow (2.07; 1.19–3.62) increased the chance of belonging to the YY-class. Conclusions Being a health professional and the visual fixation at the nasolabial furrow helped to identify the presence/absence of neonatal pain.