Pain in Children

Physical pain is an unpleasant feeling that comes with actual or potential physical injury, damage or disease. Children are sometimes too young, too sick or too afraid to say how much pain they have. To determine how much pain a child is feeling requires special communication on the part of the parent.

Pain in children may result from any of the following causes:
• Earache as a result of otitis media, glue ear, or dental problems.
• Colic (Infantile) in babies aged up to 6 months.
• Headache and migraine, possibly related to stress, allergies or food intolerance.
• Trauma following immunisation, cuts, bruises, bumps, falls or fractures.
• Abdominal pain caused by infections, food intolerance, ingestion of toxic substances, excess food intake or surgical problems such as appendicitis.
• Pain related to bacterial or viral infections such as sore throat, aching joints, skin rashes, eye irritation and blocked nose.
• Pain related to chronic diseases such as cancer or leukaemia.
The best way to assess pain is to ask the child where they hurt and how much. Measurement of pain in babies, especially sick babies, is perhaps the most difficult of all. Crying, fussing, sleeplessness, rapid heart rate and breathing and changes in facial expressions are an indication of pain.
For older children, try using a doll or teddy and ask the child to point to where it hurts. Children under 4 years of age can often tell us that they are hurting. However, they usually cannot say how much pain they feel. For children over 4-5 years of age, drawings of pain faces are often best. Children point to a face on the scale that matches how they feel. Children who are 6 or 7 years old can rate their pain on a 0-10 scale. Zero is no pain and 10 is the worst possible pain.

TREATMENT OPTIONS
For most minor pains, comfort, cuddles and a "make it better kiss" are all that is required. Always consult your Doctor if your child has pain that cannot be relieved, if the cause is unknown, or if it recurs.
Drug-free pain relief
1.Distraction is used to focus the child's attention away from the pain. Simple measures such as reading books, blowing bubbles, playing soft music and counting are good techniques for children. Touch can be an important distraction technique. Stroking, patting, bathing and rocking infants can be very effective.
2. Deep breathing is a good technique to use with young children. The child is instructed to take a deep breath through the nose and "blow away their pain" through the mouth.
3. Muscle relaxation is used to decrease mental and physical tension. A muscle relaxation exercise can be used with most children over 5 years of age. Slowly each muscle is tensed and then relaxed in a systematic way.
4. Guided imagery involves encouraging the child to imagine they are in a safe, pleasant place. When imagining a favourite place, the child is asked to feel the warmth all around, see the colors, smell the odours, and hear the sounds. This helps the child create a clear scene in their mind. A guided imagery exercise can be used with school age children and adolescents.

PHARMACIST'S ADVICE
Ask your MedAux Pharmacist for advice.
1. Ask about the range of non-drug pain relief products.
2. Ask about specific pain relief medication designed for children. Paracetamol is a suitable choice.
3. Avoid giving children aspirin. Aspirin should not be given to children under 16 years of age unless specified by a Doctor.
4. If appropriate, make sure your child has daily exercise (if necessary, after a physical examination and approval by a Doctor). Walking and swimming are examples of gentle exercise, which may help to reduce pain, particularly in the joints, muscles, ligaments and tendons of the body.
5. Consider giving your child a vitamin or mineral supplement if dietary intake is inadequate. When managing pain, the body may require extra nutrients such as the B group vitamins. Pain relievers may increase the need for certain necessary vitamins.