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Signs of Pain in a Child: Care Instructions


Pain can be hard for a child to describe. An older child may be able to describe how the pain feels or tell you whether the pain comes and goes. A toddler may complain of pain or tell you that they don't feel well.

But the signs of pain in an infant or a child who doesn't speak can sometimes be hard to recognize. Persistent crying may be the first sign of a serious illness. A child with a serious illness or problem, such as an ear infection, usually cries longer than normal. But they may show others signs like being restless or furrowing their brow.

Follow-up care is a key part of your child's treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if your child is having problems. It's also a good idea to know your child's test results and keep a list of the medicines your child takes.

How can you care for your child at home?

Watch for these signs of pain

  • The signs listed below may help you decide whether your child's pain is mild, moderate, or severe. A child with severe pain will have more of these behaviours and may be harder to comfort. Look for:
    • Changes in usual behaviour. Your child may eat less or become fussy or restless.
    • Crying that can't be comforted.
    • Crying, grunting, or breath-holding.
    • Facial expressions, such as a furrowed brow, a wrinkled forehead, closed eyes, or an angry appearance.
    • Sleep changes, such as waking often or sleeping more or less than usual. Even children in severe pain may take short naps because they are so tired.
    • Body movements, such as making fists, protecting a part of the body (especially while walking), kicking, clinging to whoever holds your child, or not moving.
  • Also look for signs of injury or illness, including:
    • Swelling, bruises, or bleeding.
    • Fever, vomiting, diarrhea, or crying during feeding. Also check for an open pin sticking the skin or a red spot that may be an insect bite.

To treat mild or moderate pain

  • Try rest, massage, or distracting your child with a book or toy to help with pain. It may also help to try a warm face cloth or cold pack. Use the one that works best for your child's pain. And make sure to put a thin cloth between the cold pack and your child's skin.
  • Give your child acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) for pain. Do not use ibuprofen if your child is less than 6 months old unless the doctor gave you instructions to use it. Be safe with medicines. For children 6 months and older, read and follow all instructions on the label.
  • Do not give aspirin to anyone younger than 18. It has been linked to Reye syndrome, a serious illness.
  • Be careful when giving your child over-the-counter cold or influenza (flu) medicines and Tylenol at the same time. Many of these medicines have acetaminophen, which is Tylenol. Read the labels to make sure that you are not giving your child more than the recommended dose. Too much acetaminophen (Tylenol) can be harmful.

When should you call for help?

Call 911 anytime you think your child may need emergency care. For example, call if:

  • You feel that your baby is extremely sick. A sick baby:
    • May be limp and floppy like a rag doll.
    • May not respond at all to being held, touched, or talked to.
    • May be hard to wake up.

Call your doctor or nurse advice line now or seek immediate medical care if:

  • Your child is in pain and you do not know why.
  • You believe your child is in severe pain.
  • Your child is very fussy and cannot be comforted.
  • Your child does not seem better after taking medicine for pain.

Watch closely for changes in your child's health, and be sure to contact your doctor or nurse advice line if:

  • Your child does not get better as expected.

Where can you learn more?

Go to

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Care instructions adapted under license by your healthcare professional. If you have questions about a medical condition or this instruction, always ask your healthcare professional. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.