Pain in Children - How to Cope with Painful Procedures

My oldest has an ulcer in her mouth. It’s her first and she’s been crying over the pain. I’m at a lost. I don’t like pain but I’ll normally just buck up and take it. However I certainly don’t expect a child to do this. Every child experiences pain differently and will need to be managed according to their differences. In researching pain in children, I ran across a great article discussing painful procedures in children. As a pediatrician and mom this is a phenomenal find! I jumped up, printed it and have been carrying it around waiting to read it in my spare moments of time. Well I read it. Here’s what I found.

In 2005 the Annals of Emergency Medicine published an article titled Pediatric Procedural Pain. In the paper they reviewed what we now know about pain and gave specific suggestions to help kids cope with painful procedures. It stated that “Pain is always subjective. Each individual learns the application of the word through experiences related to injury in early life.” This argues for reducing painful procedures as much as possible.

They listed numerous non pharmacological interventions that can be used to reduce pain and distress with procedures. Below are some highlights.

1. Distraction: For an Infant use a pacifier, bubbles, and toys. For a toddler use bubbles, songs, and toys. For school age use video games, search for objects in pictures, stories, jokes, and counting. For adolescents use music, video games, and conversation

2. Deep Breathing: Have the child take deep breaths rhythmically.

3. Blowing: Take a deep breath and “blow away the pain”.

4. Suggestion: Put on a “magic glove” or “magic cream” that doesn’t allow pain.

5. Superhero imagery: Have the child pretend they are a superhero and on a mission.

6. Guided imagery: Help the child imagine a special place that they are visiting.

7. Rewards: Tell the child there are rewards, such as stickers, available.

8. Spot pressure or counter irritation: Rub the surrounding skin or provide spot pressure to the surrounding skin.

9. Sweet solution, pacifier, breastfeeding: Useful for infants of minor procedures.

Remembering that pain is subjective can help with the frustration over a child who seems to be over reacting to the pain. Maybe they are more sensitive than others to painful stimuli. Sometimes there’s not a lot you can do to avoid the painful procedure. However there are ways that you can help them cope and manage the pain better. I hope I gave you some good ideas.

Sheila Cason, MD