Pain relief in children - Caidr
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Pain relief in children

Updated 04.04.2022
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It’s difficult to see your child in pain with earache, toothache or a sore throat, and your instinct is naturally to take that pain away. There are certain things you can try at home, and we’ll talk you through how to increase pain relief, as needed. But bear in mind that pain has a function: it alerts us that something is wrong. Your child may not be able to articulate how they feel or exactly where the pain is, so if they seem in significant pain or it’s going on for more than a few hours, if you’re unsure of the cause or they have other symptoms, don’t hesitate to seek a medical opinion. This is especially true for tummy pain, a headache or hip pain.

What should I try first?

If paracetamol or ibuprofen on their own have not helped, you can try combining them. It’s best to alternate them, so you’re giving something every 2 to 3 hours. You may need to keep a diary to keep track of what they’ve had when and avoid over- or under- dosing them. This is quite a lot of pain relief for a child, so even if you feel confident of the cause, if you’re having to give this for 24 to 48 hours, it’s worth getting advice from a doctor. If you have any reason to doubt the cause or the right way forward, don’t hesitate to seek advice sooner.

What should I try next?

If your baby or child hasn’t had ibuprofen before and they have a diagnosis of asthma, this can bring on difficulty in breathing, called bronchospasm. Avoid it if they are asthmatic and haven't tried it before, or it’s caused problems before. Ibuprofen can make asthma worse in some sufferers, so you should watch out for difficulty in breathing (bronchospasm) in asthmatics or those taking ibuprofen for the first time, and avoid it in future. Seek urgent medical attention if they are having breathing problems. Ibuprofen can also irritate the lining of the stomach, so should be taken with food and avoided if they are getting heartburn or have previous had stomach ulcers or bleeding problems. For those under 16 years, aspirin should be avoided. This is because it carries a risk of Reye’s syndrome, a rare but serious condition where the liver and brain become swollen. Do not give your child any adult medications you might have handy, like naproxen, diclofenac, codeine, co-codamol or tramadol, as these are not licensed for children. For long-term pain such as in the case of cancer treatment or ongoing inflammatory joint conditions, pain can be persistent or severe, and should be discussed with your child’s specialist or the multi-disciplinary team looking after them. They may consider prescribing other medications such as opioids (codeine or morphine) after careful consideration.

Should I avoid any medications?

It’s common for children to complain of pain, but this is usually fleeting, mild and the cause is obvious. Reassurance and distraction may be enough to ease the pain. In those less than 5 years old, they will often complain of tummy pain, as they have learned that this gets a response. Whether they have tummy pain or not, they have alerted you that they are uncomfortable and in distress, so it’s worth taking notice of this. If you are finding it hard to work out a simple cause for your child’s pain, if paracetamol and ibuprofen aren’t easing it, or if you’ve needed to give regular pain relief for more than 24 hours, any of these might be reason to consult your doctor. You know your child best, so if you think something is wrong, trust your instinct and call your doctor or NHS 111.

When should I take my child to the doctor?

It’s common for children to complain of pain, but this is usually fleeting, mild and the cause is obvious. Reassurance and distraction may be enough to ease the pain. In those less than 5 years old, they will often complain of tummy pain, as they have learned that this gets a response. Whether they have tummy pain or not, they have alerted you that they are uncomfortable and in distress, so it’s worth taking notice of this. If you are finding it hard to work out a simple cause for your child’s pain, if paracetamol and ibuprofen aren’t easing it, or if you’ve needed to give regular pain relief for more than 24 hours, any of these might be reason to consult your doctor. You know your child best, so if you think something is wrong, trust your instinct and call your doctor or NHS 111.

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