Pain in children

by | Pain, Pharmacy Care

General Information

Pain is your body’s way of telling you there is something wrong with it. Pain can be caused by an injury, such as a cut or burn, or by illness, such as a sore throat or ear infection. Pain can be acute, which means it started recently, or chronic, which means it has lasted for longer, such as weeks or months.

It is not always easy to know when your child is in pain, or to know the cause, as babies and young children are not able to tell you they are in pain. A child doesn’t necessarily have to be crying to indicate pain as some children can become quiet and withdrawn. Older children may be able to tell you where they are in pain, but may have difficulty describing it, such as how bad it is or when it started. A visual ‘faces’ pain scale can be used to report pain in younger children, whereas older children can use a numerical scale.

Signs that a baby or child is in pain may include changes in behaviour such as:

  • being unusually quiet or withdrawn
  • crying for no obvious reason
  • being agitated, anxious, angry or frightened
  • not eating or sleeping properly
  • tugging on their ears (often a sign of ear pain)
  • avoiding activities that make their pain worse

See Your Pharmacist or Medical Professional

  • if the child is under two years old
  • if you have any concerns that the pain is a sign of something more serious
  • if the child is floppy, pale or hard to wake up
  • if the child has a fit, or convulsion
  • if the child develops a rash or stiff neck
  • if the child refuses to eat for more than 24 hours, or has persistent vomiting or diarrhoea
  • if the child has a high fever
  • if the child is tugging their ears; this may be a sign of ear infection
  • if the pain does not get better after using pain relief medicine for 24 hours
  • if you think your child may have signs of meningitis, contact your doctor urgently. It is important to note that not every child will develop a rash with meningitis

Treatment Tips

  • pain relief medicines often work best if they are given regularly, rather than just when pain is bad. However, you should never exceed the recommended dose on the product
  • pain relief medicines should not be used in children for longer than a few days without medical advice
  • children under 16 years old must not take aspirin for pain or fever because it can cause Reye’s syndrome, which is a serious condition
  • other methods of reducing pain include massage or using heat or ice packs
  • distraction, relaxation, massage and behavioural techniques can be used with medicine to provide pain relief
  • children with chronic (ongoing) pain need to be treated by a doctor
  • sometimes it is hard to avoid causing a child some pain, such as when changing a wound dressing or washing a wound, or when the child is at the doctor and is given an injection or has a blood sample taken. Ways to reduce pain for your child include explaining what is happening and why, distracting the child and allowing the child some control, such as:
    • letting the child help to wash a cut or put on a dressing
    • letting the child choose the finger or arm for a blood sample or injection

Treatment Options

  • always use a proper measuring device (such as an oral syringe or calibrated measuring cup) to measure the exact dose when giving children oral liquid medicines. Teaspoons vary a lot in size and should never be used to measure medicines
  • talk to your pharmacist if you have difficulty opening or closing containers which have child safety caps on them; alternatives are usually available
  • talk to your pharmacist about the best place to store your medicines
  • as children grow, the dosage of most medicines change. Always refer to the dosing instructions on the product or ask your pharmacist if you are not sure how much to give. Most dosages for children are based on their ideal body weight

Oral pain relief medicines (analgesics)

e.g. paracetamol (Panadol Children 7+ Years Soluble Tablets)

e.g. ibuprofen (Nurofen for Children 7+ Years Chewable Capsules)

e.g. paracetamol (Dymadon for Babies 1 Month-2 Years, Dymadon for Kids Suspension 2-12 Years, Panadol Children 1 Month-1 Year Baby Drops, Panadol Children 1-5 Years Suspension, Panadol 5-12 Years Suspension, Panamax Elixir, Panadol Children 3+ Years Chewable Tablets)

e.g. ibuprofen (Advil Pain & Fever Infant Drops, Advil Pain & Fever Relief Oral Suspension, Dimetapp Children’s Pain & Fever Relief Ibuprofen Oral Suspension, Nurofen for Children Baby Drops 3+ Months, Nurofen for Children 3 Months-5 Years, Nurofen for Children 5-12 Years)

  • paracetamol is a safe choice for most children but it is important not to give more than the recommended dose
  • always follow the dose instructions for the age and weight of your child
  • paracetamol is sometimes given as suppositories if the child cannot take medicines by mouth
  • ibuprofen is not suitable for everyone; check with your pharmacist before giving ibuprofen to a child if they:
    • are dehydrated
    • have a history of stomach problems, such as ulcers or indigestion
    • have asthma; some people with asthma find their condition is made worse by this medicine
    • have kidney problems or a heart condition
    • take other medicines
  • always follow the dose instructions for the age and weight of your child
  • paracetamol and ibuprofen relieve pain and help reduce fever. Ibuprofen is an anti-inflammatory and can reduce swelling, which makes it useful for treating injuries such as sprains, or when an infection has caused swelling, such as with sore throats or ear infections

Topical treatments

e.g. choline salicylate (Bonjela Mouth Ulcer Gel, Bonjela Teething Gel, Seda-Gel), benzocaine (Solarcaine), lidocaine (lignocaine) lower strength (Soov Burn Spray, Soov Cream)

e.g. lignocaine, higher strength (Seda Lotion, Medijel Gel, SOOV Bite Gel), lignocaine + prilocaine (Emla Cream and Patches, Numit Cream)

  • Bonjela or Seda-Gel can help relieve pain from mouth ulcers or teething problems; they can only be used for infants over the age of 4 months
  • topical anaesthetics, such as lidocaine (also known as lignocaine), can relieve skin pain caused by sunburn, bites or cuts and grazes
  • creams or patches containing lignocaine and prilocaine can be used to numb part of the skin before the child is given an injection or a blood sample is taken

More Information

Phone helplines

If you are concerned about your child there is a national 24-hour health advice helpline and also parenting helplines:

National helplines

  • healthdirect 24-hour health advice line: 1800 022 222
  • Pregnancy, Birth & Baby Helpline: 1800 882 436

Availability of medicines

  • GENERAL SALE available through pharmacies and possibly other retail outlets.
  • PHARMACY ONLY available for sale through pharmacies only.
  • PHARMACIST ONLY may only be sold by a pharmacist.
  • PRESCRIPTION ONLY available only with a prescription from your doctor or other health professional.

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