This began to change in the 1980s and ’90s, when research revealed newborns’ physiological and behavioral pain responses—leading to new standards of neonatal care. In 1987, the American Academy of Pediatrics deemed neonatal operations without local anesthetic unethical, and US medical practices shifted to implement neonatal anesthetic. While clinical research was not new to medicine, previously, doctors often favored expert opinion by the doctors with respected practice and reputation. Additionally, with the onset of digitized medical records, tracking medical data over time is much faster and cheaper. That’s partly a consequence of surgery—now with safe neonatal anesthetic.