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Pain in Children

Managing Pain in Children

​​​All children, even babies, can feel pain. When a child’s pain is left untreated, it can cause negative effects such as being 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 from an injury or procedure, but this often isn’t the cause. For example, headaches and stomach pains can happen any time for no obvious reason.

How can I tell if my child is in pain?

Crying is one way your child may show they are 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
  • 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 9, 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.

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

There are ways to manage your child’s pain without using medicines.

Use an ice pack, warm blanket, or try getting 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 medicines to help manage pain.

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

If your child is having pain for an unknown reason or pain that isn’t expected, 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)
  • ibuprofen (Advil or Motrin)

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

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.​

If your child is having a test or procedure that is expected to cause a lot of pain, it’s important to give pain medicine early so it can be prevented and relieved 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. Talk to your pharmacist.

If a non-prescription pain medicine doesn’t help manage your child’s pain or your child is in severe pain, their healthcare provider may prescribe a stronger pain medicine to help relieve the pain.

Ask your child’s doctor or pharmacist to help you choose a medicine and the dose of medicine that is 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 class of prescription medicines that treat pain. Morphine is an opioid that is sometimes prescribed to manage pain when other pain medicines, such as acetaminophen or ibuprofen, don’t work. It can be given into a vein (called intravenous or IV morphine) or given by mouth as a pill or liquid. Morphine is safe to use in children, including newborn babies.

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.

There are other types of opioids that may be prescribed for your child, depending on the type of pain they have, how bad the pain is, and what other medicines they have had in the past.

It’s normal to have concerns if your child needs to take morphine. You may worry they will get addicted to this medicine. The risk of addiction is rare in children who use an opioid like morphine to treat pain. If you are 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. Contact your child’s healthcare provider right away if they:

  • have red, swollen, itchy, and raised patches on their skin (called hives)
  • are very sleepy and hard to wake up
  • have 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 hospital Emergency Department. If your child has trouble breathing or you can’t wake them up, call 911.

There are more common side effects of opioids that don’t need medical help and will likely go away within a few days of starting the medicine. These side effects include:

  • nausea
  • feeling a bit sleepy (drowsy)
  • feeling itchy without hives

Another common side effect of taking opioids is having stool that is 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.

Current as of: May 22, 2019

Author: Pharmacy Services, Alberta Health Services