Pain Management (Acute) – Children

Causes of pain in children include:

If you think a child is in pain, they should always be seen by a GP for diagnosis and treatment.

It may not be necessary to give a child a pain medicine. Many other treatments are available that can help relieve a child’s pain. If a pain medicine is needed, always read the label and follow dosage instructions exactly after you have been provided with written consent from the child’s parent or guardian.

For mild pain, such as pain from a new tooth, over-the-counter children’s paracetamol or ibuprofen may be helpful. These are often used in combination with non-medicine strategies. In more serious cases (such as pain from a broken bone), a doctor may need to prescribe stronger medicines.

How to measure pain in children

Measuring a child’s pain level can be tricky, particularly in babies and very young children who have no direct way to communicate.

Suggestions include:

  • See how the child responds to the pain. They may cry, moan and groan, grimace, writhe, cradle the sore body part or protect it from accidental bumps.
  • See how the child looks. They may be flushed and sweaty, or look pale and tired.
  • See how the child behaves. They may be quieter than usual or more irritable, stop playing, lose their appetite, be listless or regress to behaviours they have outgrown such as thumb sucking.
  • Listen to the child. If they are old enough, they may be able to use words or drawings to communicate the severity of the pain.
  • Ask a child (7 years or older) to rate their pain on a scale of 0 to 10 with 0 being ‘no pain’ and 10 being the worst pain.
  • Measure physical reactions. The doctor can check for physical signs of pain such as heart rate, blood pressure and blood oxygen levels.
  • For parents trust your parental instincts. No one knows your child better than you do.

Strategies for managing pain in children

Many non-medicine treatments can be used to relieve a child’s pain. Non-medicine techniques fall into 3 categories including environmental (such as a calm atmosphere), physical (such as hugging) and distraction techniques.

Environmental techniques include:

  • Swaddle or wrap babies.
  • Show the child that you are taking their pain seriously.
  • Tell them what is happening using words they can understand. Fear and anxiety are known to increase perception of pain.
  • Reassure them that their pain will be managed and that the treatment (such as an injection) will be less painful than the pain itself.
  • Allow your child some control over the situation – for example, older children could decide whether to take their pain medication as a syrup or tablets and ask what flavour of syrup they prefer.

Physical techniques include:

  • Give plenty of cuddles and attention.
  • If a child is teething, simple measures such as gently massaging the gum with a clean finger or giving them a teething ring to chew may help to relieve discomfort.
  • Icepacks or heat treatments can reduce pain. Ask your doctor for advice.

Distraction techniques include:

  • Distract your child with games, books or favourite television shows.
  • Your health professional may give a baby younger than 12 months a sucrose solution to help with painful procedures.
  • If your baby is younger than 6 months and you are breastfeeding, feed them while they are receiving a painful procedure like vaccination.

Unhelpful pain-management strategies

Some approaches only increase a child’s fear and anxiety. Unhelpful strategies that are best avoided include:

  • Fake reassurance – don’t tell them that a procedure, such as an injection, won’t hurt when you know it will.
  • Belittling – don’t ridicule your child for acting ‘like a baby’ in the hope they will respond with bravery.
  • Being anxious yourself – don’t fixate on their pain or scare them with talk about future suffering they may have. Research shows that a person who expects the worst will perceive their pain as more painful.



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