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Pain in Children

Managing pain in children

​​​​​​​​​​​​​​​​​​​​​​All children, even babies, can feel pain. When a child’s pain is untreated, it can cause them to heal more slowly or be more sensitive to pain as they get older. This is why it’s important to know how to tell if a child is in pain, what you can do to treat it, and when to get medical care.​

Children may have pain right after an injury or medical procedure, but sometimes it’s not clear what causes pain to start. For example, headaches and stomach aches can happen any time, and sometimes for no obvious reason.

How can I tell if my child is in pain?

Crying is one way your child may show they're in pain. But there are other ways children may react.

Very young children (infants and toddlers) may:

  • act fussy
  • not eat well (lose their appetite)
  • hold on tightly to a body part that hurts and curl up
  • be hard to soothe
  • be quieter than usual
  • not move as much

Older children may be able to tell you they’re in pain. If you think your child is in pain, you can ask them using words they’ll understand, such as “Do you have an owie?” or “Are you hurt?”

If they say yes, ask if it hurts a little or a lot. If your child is older than 6, you can ask them to rate their pain on a scale of 0 to 10, with 0 being no pain and 10 being the most pain they can imagine.

But remember, everyone’s pain is different, and your child’s 7 out of 10 pain may not mean the same thing as your 7 out of 10 pain. It’s important to talk to your child and understand what they need.

What can I do to help manage my child’s pain?

There are ways to manage your child’s pain without using medicines, such as:

  • using an ice pack or a warm blanket
  • trying to get your child to focus on other things, such as playing with toys or bubbles, listening to music, or watching TV

You can use these strategies with or without medicine to help manage pain.

If your child is in pain, let them know you understand they're in pain and treat it based on their age and medical condition.

If your child is having pain for a reason that you don’t know or the pain appears to be more than you’d expect, talk to your child’s healthcare provider or call Health Link at 811 to find out what to do.​

What medicines can I give my child to help treat or prevent pain?

To treat your child’s pain, you can give them a non-prescription (over-the-counter) pain medicine such as acetaminophen (Tylenol or Tempra) or ibuprofen (Advil or Motrin).

You can get these medicines as a liquid, pill (tablets) or chewable tablets. Acetaminophen and ibuprofen both treat pain and a fever. Ibuprofen is also an anti-inflammatory medicine, so it’s a better option to manage pain in injuries with swelling.

If your child is having a test or medical procedure that will likely cause pain, it’s important to use the strategies mentioned above and pain medicine early to prevent and lessen pain before it gets worse.

To prevent pain from a blood test, you can put on a cream that numbs your child’s skin before the test. You can get a numbing cream without a prescription (called a non-prescription medicine). Talk to your pharmacist.

If a non-prescription pain medicine doesn’t help treat your child’s pain or your child has a lot of pain (serious pain), their healthcare provider may prescribe a stronger pain medicine to help lessen the pain.

What dose should I give my child?

The dose of these medicines is based on your child’s weight. Follow the directions on the container or the advice of your child's doctor or pharmacist.

Ask your child’s doctor or pharmacist to help you choose a medicine and dose that’s best for your child. If your child’s pain doesn’t get better after a few days of using a non-prescription pain medicine, talk to your child’s healthcare provider.

Morphine and other opioids

Opioids are type of prescription medicine that treat serious pain. Morphine is an opioid that's sometimes prescribed to manage pain when other pain medicines, such as acetaminophen or ibuprofen, don’t work. Your child may get morphine through a vein (called intravenous or IV morphine) or by mouth as a pill or liquid. Morphine is safe to use in children, including newborn babies, for short amounts of time.

The dose of morphine is based on your child’s age and weight. If your child is still having pain or has side effects after taking morphine, their healthcare provider may raise or lower the dose. Your child’s healthcare team will let you know if the dose needs to be changed.

Your child’s healthcare provider may prescribe other types of opioids, like oxycodone or fentanyl, depending on the type of pain they have, how bad the pain is, and what other medicines they’ve had in the past.

It’s normal to have concerns if your child needs to take an opioid pain medicine. You may worry about side effects or addiction. The risk of addiction is rare in children who use an opioid like morphine to treat pain for a few days. If you’re worried about addiction or have other questions or concerns about opioid medicines, talk to your child’s healthcare provider.

What are the side effects of morphine and opioids?

As with all types of medicines, opioids can cause side effects. Some common side effects of opioids don’t need medical help and will likely go away within a few days of starting the medicine. These side effects include feeling:

  • sick to your stomach (nausea)
  • a bit sleepy (drowsy)
  • itchy
Another common side effect of taking opioids is having stool that’s hard to pass (called constipation). Constipation from taking opioids won’t go away with time and may even get worse.

Talk to your child’s healthcare team about ways to prevent and treat constipation. They may prescribe laxatives or stool softeners to help your child manage constipation. You can also give your child plenty of fluids to help lessen constipation.

When should I get medical help?

Contact your child’s healthcare provider right away if your child:
  • has red, swollen, itchy, and raised patches on their skin (called hives)
  • is very sleepy and hard to wake up
  • has trouble breathing or their breathing is slow and shallow (not deep)

If you can’t reach your child’s healthcare provider, go to the nearest urgent care centre or emergency department. If your child has trouble breathing or you can’t wake them up, call 911.​

Current as of: February 18, 2021

Author: Solutions for Kids in Pain, Alberta Health Services