Managing your child's pain

What is pain?

Pain is an uncomfortable feeling that lets us know something may be wrong in our body. Acute pain is short lived pain that can last from a few minutes to a few days and is usually caused by physical injury, surgery or disease. When injury or disease occurs at a site in your body, a message is sent from that area along the spinal cord to the brain, where pain is then perceived. Some common words used to describe pain are: achy; throbbing; stabbing; or sharp.

Sometimes our body feels pain with no obvious cause or for longer than anticipated after injury, surgery or disease. This is known as complex pain. The cause and management of complex pain is different to acute pain, and will not be covered in this information.

Assessing your child's pain

Assessing your child's pain is an important part of successful pain management. The staff caring for your child at Starship are skilled in assessing children's pain. There are a range of pain assessment tools that can be used with children of varying ages, from newborn babies to teenagers, to help determine your child's level of pain. By talking to your child they can also assess what might be causing the pain and what makes it better or worse. This information is found out by talking to your child directly, looking at their behaviour and what their body is doing, and talking with you, the parent/carer.

No one is as familiar with your child's normal behaviour as you - please let us know if you feel your child is behaving differently.

Treating pain

The medicines that we use to treat acute pain all work on the body in different ways. We start with simple medicines like Paracetamol and depending on the intensity of the pain, may add stronger medicines such as Morphine, as needed.

For children with moderate to severe pain, it is important that we continue to give simple medicines at regular times -  they help the stronger medicines to work better and reduce the amount that is needed. By doing this, we are providing the safest, most effective, pain relief possible.

We try to arrange that these medicines are given without disturbing your child too much, but it is sometimes necessary that they are woken/disturbed. This regular and balanced approach can lead to improved pain management and avoid delays in recovery and discharge home.

Concerns you may have about the medication

Children in severe pain may require pain relief medications called opioids, such as Morphine. These are given through an intravenous drip or via the mouth as a tablet or liquid. Some parents have concerns about addiction with these medicines. However, when opioids are used for a short time for pain control, your child will not become addicted. At Starship these medications are used in a safe way under medical supervision with controlled doses.

What you can do to help

There are number of techniques, known as non-pharmacological pain management, you as a parent/carer can use or suggest to nursing or medical staff when your child is in pain. Methods such as distraction, education and positioning have been found to be effective in decreasing pain and anxiety in children. These will not only assist in managing your child's pain but allow you as a parent/carer to be involved.

As a parent you know what your child likes and dislikes, how they may react to certain situations and what their level of understanding is. You are a great resource to the medical staff! Please do not hesitate to share your knowledge of your child and your thoughts with your nurse at Starship.

Some non-pharmacological techniques are outlined below. These are more often used in combination with pain relieving medications, rather than on their own, to ensure your child has well-rounded pain management.

Distraction/Alternative focus

Distraction techniques take the child's focus away from the pain and places their attention on a more pleasant activity.

Some suggestions for distraction are outlined below:

Development StagesAlternative Focus
Infant
0-12 months
• Comfort positioning
• Music
• Dummy
• Bottle
• Parents
• Breastfeeding
Toddler
1 - 3 years
• Bubbles
• Looking at pictures
• Pop up books
• Comfort positioning
• Videos on your phone
• Toys from home
• Virtual Reality
Pre-school
3- 5 years
• Storybooks
• Music
• Videos or pictures on your phone
• Talking
• Interactive toys
• Bubbles
• Virtual Reality
School age
6 - 12 years
• Deep breathing
• Positioning
• Phone or electronic tablet
• Talking
• Counting
• Search and find books
• Virtual Reality
Young People
12 - 18 years
• Conversation
• Deep breathing
• Phone or electronic tablet
• Listening to music
• Relaxation techniques - picture yourself at your favourite spot.
• Virtual Reality

Education/Accurate Information

If children are aware of what is going on it can decrease their anxiety and fear and in doing so their pain. This is very age dependent and the education or information should be honest and aimed at a level your child understands.

Play Specialists

Play specialists can be found in every area throughout Starship. They have a wealth of knowledge on hospital based medical play and distraction techniques. They are a fantastic source of help with non-pharmacological pain management options. Just ask your nursing staff if you haven't met your play specialist yet and would like to.

Who to contact for help and advice

If you are concerned your child is in pain while at Starship or you feel that they need further pain management please let the medical or nursing staff know so they can assist. By working in partnership with the healthcare team it will allow us to work towards achieving the best pain control for your child.