How do infants experience pain. What are the signs of pain in babies. How can parents help manage their infant’s pain. What non-medicinal methods can reduce pain in infants. How do healthcare professionals assess and treat pain in babies. What causes pain in infants. How does the Children’s Comfort Promise approach pain management.

Understanding Pain in Infants: Dispelling Common Myths

For many years, it was believed that infants didn’t experience pain in the same way adults do. However, modern research has definitively shown that babies do indeed feel pain, and it can be just as intense and distressing for them as it is for older children and adults. This recognition has led to significant changes in how healthcare providers approach pain management for their youngest patients.

Do infants really feel pain? The answer is a resounding yes. Despite their inability to verbalize their discomfort, babies have fully developed pain receptors and nervous systems that allow them to experience pain acutely. In fact, some studies suggest that infants may be even more sensitive to pain than adults due to their developing nervous systems.

Common Causes of Pain in Infants

Pain in infants can arise from various sources, including:

• Post-surgical discomfort
• Medical procedures (e.g., blood draws, IV insertions)
• Infections
• Prolonged immobility
• Irritation from medical devices or tubes
• Skin abrasions or pressure sores

Understanding these potential sources of pain is crucial for both healthcare providers and parents in order to effectively address and manage an infant’s discomfort.

Recognizing Pain Signals in Infants: A Guide for Parents and Caregivers

While infants cannot verbally communicate their pain, they exhibit various behavioral and physiological cues that can indicate discomfort. Being able to recognize these signs is essential for prompt and effective pain management.

Behavioral Indicators of Pain in Infants

Infants in pain may display the following behaviors:

• Intense, high-pitched crying
• Facial grimacing or furrowed brow
• Muscle tension or rigidity
• Restlessness or irritability
• Changes in sleep patterns
• Decreased appetite or refusal to eat
• Unusual quietness or withdrawal

It’s important to note that these behaviors can vary between infants and may even be inconsistent in the same baby at different times. Healthcare professionals often use a combination of these indicators to assess an infant’s pain level.

Physiological Signs of Pain

In addition to behavioral cues, healthcare providers may monitor certain physiological signs to gauge an infant’s pain level:

1. Increased heart rate
2. Elevated blood pressure
3. Faster breathing rate
4. Changes in oxygen saturation levels

These vital signs can provide objective data to support pain assessment in infants, especially when combined with behavioral observations.

The Children’s Comfort Promise: A Comprehensive Approach to Pain Management

The Children’s Comfort Promise is a groundbreaking initiative that prioritizes pain prevention and management in pediatric care. This approach recognizes that effective pain control is not just a medical necessity but a fundamental right of every child.

How does the Children’s Comfort Promise work in practice? It involves a multidisciplinary team approach, combining both pharmacological and non-pharmacological interventions to address pain and anxiety in young patients. This holistic strategy ensures that all aspects of a child’s well-being are considered when developing a pain management plan.

Key Principles of the Children’s Comfort Promise

• Proactive pain prevention
• Prompt assessment and treatment of pain
• Collaboration between healthcare providers and families
• Utilization of both medicinal and non-medicinal therapies
• Ongoing education for staff and families about pain management

By adhering to these principles, healthcare facilities can create an environment where pain is minimized, and children’s comfort is prioritized throughout their medical journey.

Non-Medicinal Pain Relief Strategies for Infants

While medication plays a crucial role in managing severe pain, numerous non-pharmacological approaches can be highly effective in reducing discomfort and promoting relaxation in infants. These methods are often preferred as first-line interventions due to their safety and lack of side effects.

Environmental Modifications

Simple changes to an infant’s surroundings can have a significant impact on their comfort level:

• Reducing ambient light and noise
• Minimizing unnecessary disturbances
• Maintaining a comfortable room temperature
• Creating a calm, soothing atmosphere

Comfort Measures

Physical comfort techniques can help alleviate pain and promote relaxation:

• Gentle rocking or swaying
• Swaddling or containment holding
• Skin-to-skin contact (Kangaroo Care)
• Soft massage or touch
• Use of a pacifier for non-nutritive sucking

Distraction Techniques

Engaging an infant’s senses can help divert attention from pain or discomfort:

• Soothing music or white noise
• Gentle singing or talking
• Visual stimulation with age-appropriate toys
• Use of bubbles or other captivating visual elements

Nutritive Interventions

Certain nutritive strategies have shown promise in reducing pain during minor procedures:

• Breastfeeding during painful procedures
• Administration of small amounts of sucrose solution

These non-medicinal approaches can be used alone or in combination with pharmacological interventions to provide comprehensive pain relief for infants.

The Critical Role of Parents in Infant Pain Management

Parents play an invaluable role in managing their infant’s pain. Their intimate knowledge of their baby’s normal behavior and temperament makes them uniquely positioned to detect subtle changes that may indicate discomfort. Moreover, a parent’s presence and touch can provide significant comfort to an infant undergoing medical procedures or experiencing pain.

How Can Parents Contribute to Pain Management?

There are several ways parents can actively participate in their infant’s pain management:

• Communicating observations about the baby’s behavior to healthcare providers
• Participating in pain assessment by reporting changes in the infant’s usual patterns
• Providing comfort through touch, holding, or skin-to-skin contact
• Assisting with distraction techniques during procedures
• Advocating for their child’s pain management needs
• Learning and implementing non-pharmacological pain relief strategies

By actively engaging in their infant’s care, parents can significantly enhance the effectiveness of pain management strategies and promote a more positive healthcare experience for their baby.

Pharmacological Approaches to Infant Pain Management

While non-medicinal strategies are often the first line of defense against infant pain, there are situations where pharmacological interventions become necessary. The use of pain medication in infants requires careful consideration and close monitoring due to their unique physiology and potential for side effects.

Common Pain Medications for Infants

Healthcare providers may use various medications to manage pain in infants, depending on the severity and cause of the discomfort:

• Acetaminophen (Paracetamol): For mild to moderate pain
• Ibuprofen: For infants over 6 months, to manage pain and inflammation
• Opioids: For severe pain, typically in post-surgical settings
• Local anesthetics: For pain relief during minor procedures

The choice of medication, dosage, and administration method is carefully determined based on the infant’s age, weight, medical condition, and the specific pain-causing situation.

Considerations in Pharmacological Pain Management for Infants

When using pain medications in infants, healthcare providers must consider several factors:

1. Age-appropriate dosing to ensure safety and efficacy
2. Potential drug interactions with other medications the infant may be receiving
3. Monitoring for side effects, which may present differently in infants compared to older children or adults
4. Balancing pain relief with the need to maintain alertness for feeding and bonding
5. Long-term effects of pain medications on the developing nervous system

Given these considerations, the use of pain medications in infants is always carefully weighed against the potential benefits and risks, with a focus on providing effective pain relief while minimizing adverse effects.

Assessing Pain in Infants: Tools and Techniques for Healthcare Providers

Accurately assessing pain in infants is crucial for effective management, but it presents unique challenges due to the inability of babies to self-report their discomfort. To address this, healthcare providers utilize various tools and techniques to evaluate pain levels in their youngest patients.

Pain Assessment Scales for Infants

Several validated pain assessment scales have been developed specifically for use with infants:

• NIPS (Neonatal Infant Pain Scale): Assesses facial expression, cry, breathing patterns, arms, legs, and state of arousal
• FLACC Scale (Face, Legs, Activity, Cry, Consolability): Used for infants and young children
• PIPP (Premature Infant Pain Profile): Designed for premature infants, considering gestational age
• CRIES (Crying, Requires oxygen, Increased vital signs, Expression, Sleeplessness): Used in post-operative settings

These scales provide a structured approach to pain assessment, allowing healthcare providers to quantify pain levels and track changes over time.

Multidimensional Approach to Pain Assessment

Effective pain assessment in infants often involves a combination of methods:

1. Behavioral observation using validated scales
2. Physiological measurements (heart rate, blood pressure, oxygen saturation)
3. Parent/caregiver input on changes in the infant’s normal behavior
4. Consideration of the context (recent procedures, known medical conditions)
5. Response to pain relief interventions

By integrating multiple sources of information, healthcare providers can build a comprehensive picture of an infant’s pain experience and tailor management strategies accordingly.

Long-Term Impact of Unmanaged Pain in Infancy

The importance of effective pain management in infants extends beyond immediate comfort. Research has shown that unmanaged pain during infancy can have lasting effects on a child’s development and future pain perception.

Potential Consequences of Untreated Pain in Infants

Studies have identified several potential long-term impacts of inadequately managed pain in early life:

• Altered pain sensitivity and processing in later childhood and adulthood
• Increased risk of chronic pain conditions
• Developmental delays or alterations in brain structure
• Higher levels of stress and anxiety during future medical procedures
• Potential impacts on cognitive and emotional development

These findings underscore the critical importance of comprehensive pain management strategies for infants, not just for immediate relief but for long-term health and well-being.

The Role of Early Pain Experiences in Shaping Pain Responses

Early pain experiences can shape how the nervous system develops and responds to pain stimuli in the future. This phenomenon, known as pain sensitization, highlights why effective pain management in infancy is crucial for healthy development.

How does early pain experience affect future pain responses? Research suggests that repeated painful experiences without adequate management can lead to:

1. Lower pain thresholds in later life
2. Heightened anxiety during medical procedures
3. Altered stress responses
4. Potential changes in pain-related brain regions

By prioritizing pain management in infancy, healthcare providers and parents can help mitigate these potential long-term effects and promote healthier pain processing throughout the child’s life.

Innovations in Infant Pain Management: Current Research and Future Directions

The field of infant pain management is continually evolving, with ongoing research aimed at developing more effective and tailored approaches to alleviating discomfort in our youngest patients. These innovations promise to enhance our ability to assess and manage pain in infants, potentially leading to improved short-term comfort and long-term outcomes.

Emerging Technologies in Pain Assessment

Researchers are exploring new technologies to provide more objective measures of infant pain:

• Advanced neuroimaging techniques to visualize pain responses in the infant brain
• Wearable devices that continuously monitor physiological indicators of pain
• Machine learning algorithms to analyze facial expressions and body movements for pain cues
• Near-infrared spectroscopy to measure cortical responses to painful stimuli

These technologies aim to provide more accurate and real-time pain assessments, enabling healthcare providers to respond more quickly and effectively to an infant’s discomfort.

Novel Pharmacological Approaches

Research into new pain medications and delivery methods for infants is ongoing:

1. Development of age-specific formulations with improved safety profiles
2. Exploration of topical analgesics for needle procedures
3. Investigation of non-opioid alternatives for managing severe pain
4. Research into the use of medical cannabis derivatives for specific conditions

These pharmacological innovations seek to provide more targeted pain relief while minimizing potential side effects and long-term impacts on infant development.

Advanced Non-Pharmacological Interventions

Researchers are also exploring enhanced non-medicinal approaches to pain management:

• Virtual reality distraction techniques adapted for infant use
• Customized music therapy interventions based on individual infant responses
• Advanced swaddling and positioning techniques for specific medical procedures
• Robotic comfort devices designed to mimic human touch and movement

These innovative non-pharmacological methods aim to provide more effective pain relief and comfort for infants undergoing medical procedures or experiencing chronic discomfort.

Personalized Pain Management Strategies

The future of infant pain management lies in personalized approaches that consider individual factors:

1. Genetic profiling to predict pain sensitivity and medication response
2. Tailored pain management protocols based on an infant’s unique physiological and behavioral characteristics
3. Integration of parental preferences and cultural considerations into pain management plans
4. Development of AI-assisted decision support tools for healthcare providers

Pain in Infants (Babies)

Article Translations: (Spanish) (Hmong) (Somali)

Our commitment to pain management

We believe infants have a right to the best level of pain relief that can be safely provided. The Children’s Comfort Promise™ states we will do everything possible to prevent and treat pain, so we take a team approach to pain and anxiety management, using medicine and non-medicine therapies. Our goal is to have staff and families work together to assess pain promptly and treat it effectively.

Do infants have pain?

Even though infants are still developing and cannot tell us about their pain, they do feel pain, and their pain can be treated. The health care team will do all they can to relieve pain and make your baby comfortable.

Why do infants have pain?

Pain can have many causes, including:

• soreness after surgery caused by:
• the incision (an opening made in surgery)
• stretching or swelling of tissue or organs
• procedures such as starting an IV or drawing blood for a lab test
• nerves that sense tissue damage or swelling
• an achy feeling that can be caused by an infection
• sore muscles from being in bed for a long time
• discomfort from tubes
• skin abrasions or sores

How do we know an infant is in pain?

Infants cannot tell us about their pain in words, like older children, but they do give us clues by certain behaviors. We can measure pain by observing things like sleep, irritability, restlessness, appetite, movement, and vital signs (heart rate, breathing rate, blood pressure) to help decide if your baby is having pain.

How do infants act when in pain?

Infants will act differently when they are in pain than when they are comfortable. Each infant will respond individually and may be inconsistent in how they react from time to time. Infants use a combination of behaviors to signal pain. These signs may occur when the infant is not in pain, but combinations are usually present in an infant with pain. Look for the clues listed below. 

• Crying: Your baby may cry robustly. Crying is often increased in pitch and length of time. Babies who are very sick or premature and have less energy may be silent even though they are uncomfortable.
• Facial expression: Babies may have a furrowed or deeply wrinkled brow with eyes squeezed shut. Sometimes their chin quivers. Even babies on breathing machines may do this.
• Muscle tension: Babies will tense up their muscles, pulling the arms in and the legs up or sometimes stretching everything out (this is called flailing). They may also clench their fists or keep their body rigid. Babies who are very sick may lose muscle tension and become floppy.
• Babies in pain are also often irritable, restless, may refuse to eat and might be unable to sleep.
• Movement will depend on your baby’s health status and energy level. Some babies will squirm and vigorously bend arms and legs. Babies that are frail may be very quiet and not move.
• Sleep/wake patterns: Babies in pain are often fussier and sleep less. Some babies may withdraw and seem to be asleep all the time.

What can parents do?

Parents have a very important role. Because you know your baby best, you can work closely with Children’s staff (such as doctors, nurses, or child life specialists) to make decisions about managing pain. You are the best person to help your baby deal with new or difficult situations. To help your baby cope with pain, you can:

• Be present, or ask others who know your baby to visit.
• Tell the staff if you think the pain is not being controlled, or if your baby is ready to have pain medicine decreased because he or she is too sleepy or more active.

Use routine calming activities before and after a stressful event: gently patting or massaging your baby, holding, rocking, or talking in a soothing voice.

What can be done to reduce pain?

Non-medicine methods

Pain is both a physical and emotional state. Infants feel pain in their body, and they may also have thoughts and memories about pain. Because infants do not yet have language, it is hard for us to know exactly what they think of it. We will partner with you to try  and reduce both the feelings and the worry about pain. Here are some things that can help reduce pain for your baby:

• Change the infant’s environment. Less light, noise, and activity at the bedside will often help calm your baby.
• Sucking on a pacifier can help an infant cope with procedures and other painful events.
• Sugar water (24 % sucrose) is often used before, during, and after needle and other procedures to help with pain. (See the education sheet for Sucrose 24%)
• Distractions like using a soothing voice, music, stories, or songs can take an infant’s attention away from the pain or the procedure.
• Holding your baby; rhythmic motion, rocking or other slow, steady movement can help.
• Positioning infants so that they are more contained and warmer can be very comforting.
• Doing Kangaroo Care or skin-to-skin contact can be very soothing and relieve pain.
• Rubbing or gentle massage helps relax the muscles and the nerves that send pain messages to the brain, so the brain does not sense as much pain.

We will help you to learn how to use any or all of these techniques with your baby. Please check with your child’s nurse or provider to learn more.

Medicines 

There are many types of pain medicines we can use. Which type is best for your baby will depend on many things, including the type of pain, how long it will last, and the reason your child has pain. Some medicines are described below.

Numbing cream, such as 4% lidocaine, can be put on the skin to numb it before a needle procedure such as an IV start, lab draw, or injection. It has to be on for at least 30 minutes to work best and help reduce discomfort with needles. It is not usually used on babies less than 37 weeks of gestation. (See the education sheet, ” Anesthetic (Numbing) cream.”)

Non-steroidal anti-inflammatory drugs (NSAIDs) reduce pain and inflammation. They can be bought over the counter and help manage mild to moderate pain. To reduce stomachache, they should be taken with food or formula when possible. Ibuprofen (Pediaprofen®, Motrin®, Advil®, or another brand) is an example of an NSAID.

Acetaminophen (Tylenol® or another brand) is another over-the-counter medicine that helps treat mild to moderate pain. It has fewer side effects than NSAIDs but does not reduce inflammation.

Opioids are strong medicines used to treat moderate to severe pain, often used after surgery. They may be given by IV or taken by mouth. Opioids can have side effects of itching, nausea, and constipation. Infants will often become sleepy and their breathing can slow down. Sometimes NSAIDs or acetaminophen and opioids are used together. To prevent constipation, your baby may need more fluids than usual, or a stool softener.

After your baby goes home, follow your doctor’ instructions about giving pain medicines. Give the medicine as soon as the pain starts. Severe pain is harder to take away. Be sure to give medicine at bedtime to help your baby sleep comfortably. Some medicines need to be given around the clock. Your doctor will tell you the schedule for this if it is needed.

Be sure to call the doctor if the medicine does not seem to help the pain, or if the pain becomes worse. If you call the doctor about pain you might be asked if your baby has a fever, how severe the pain is based on how your baby is acting, and what the wound or surgical site looks like (if there is one).

Questions?

This sheet is not specific to your child but provides general information. If you have any questions or concerns, please talk to the doctor or the staff working with your child. Your doctor or nurse can also access other pain experts in the hospital. Good pain management is a team effort.

Last Reviewed 6/2020

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Pain management in babies | Pregnancy Birth and Baby

Pain management in babies | Pregnancy Birth and Baby

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If you have given your child too much ibuprofen or paracetamol, call the Poisons Information Centre (13 11 26) immediately or take them to your nearest hospital emergency department.

Key Facts

• Your baby can’t tell you when they are in pain, so it’s a good idea be aware of the signs.
• In the first year of life, your baby will have vaccinations and may undergo procedures like blood tests that cause minor pain and distress, but they are very important since they help keep your baby well.
• There are many ways to help reduce your baby’s pain including talking or singing to your baby, breastfeeding, swaddling and taking your baby to a dark, quiet room.
• Medicines like paracetamol and ibuprofen can be used for temporary relief of pain and discomfort.
• Any baby or young child who is unwell or in moderate to severe pain should see a doctor to find the source of the pain.

How do I know if my baby is in pain?

It can be difficult to know if a baby is in pain since they can’t directly communicate how they are feeling, but there are signs that can help you recognise when they are in pain. For example, if a baby is in pain:

• they may cry or whimper and be unable to settle
• they may be tense, with clenched fists and may keep their arms and legs close to their chest
• they may be fidgety, agitated or have an disturbed wake / sleep schedule
• they may be pale, flushed or sweaty
• they may shut their eyes tightly, furrowing their eyebrows or have larger than normal pupils

As a parent, you know your child best — if you notice your baby sounds, looks or behaves in an unusual way and you are worried they may be in pain, seek medical advice.

A doctor or baby health clinic can check for other signs that your baby might be unwell, such as an unusual heart rate or blood pressure.

Pain during procedures

In the first year of life, your baby will undergo several medical procedures. These cause minor pain and distress, but they are very important since they help keep your baby well.

In the first 3 days of your newborn’s life, a small amount of blood will be taken from their heel. This newborn screening test (or ‘heel prick test’) is done to check for rare but serious conditions. You will also be offered a number of vaccinations, which help prevent some serious contagious diseases.

If your baby is born prematurely, or with a medical problem, they may also require blood tests, feeding tubes, intravenous (IV) lines, surgery or other medical procedures. While these procedures may cause your child some pain in the short-term, the aim is to ensure their long-term health and wellbeing.

How can I help my baby in pain?

You are one of the greatest sources of comfort to your baby, and just being close to them may have a calming effect.

Some good pain reducing techniques include:

• talking or singing to your baby
• taking your baby to a dark, quiet space
• swaddling your baby
• breastfeeding or offering your baby a dummy
• nappy changing

Other pain reducing techniques involve touching or holding your baby in a certain way. Useful techniques include:

• tactile soothing (stroking your baby’s head and back softly)
• ‘kangaroo care’ (skin-to-skin contact between you and your child, where you are both covered by a blanket)
• holding your baby with both hands (to provide a feeling of security)
• letting your baby hold your finger

If your newborn undergoes a painful procedure, their doctor or nurse may suggest you breastfeed or hold your baby skin-to-skin if possible, or give them a sugar (sucrose) solution. These techniques are proven to have a calming and pain relieving effect on infants.

Video provided by Sharing Knowledge About Immunisation (SKAI)

When can I give my child medicine for pain-relief?

You can give your child medicines such as paracetamol and ibuprofen for short-term relief of symptoms such as pain or fever. While they won’t make the cause of the pain go away, they will make your baby feel and sleep better

• Paracetamol may be given from 1 month of age, every 4 to 6 hours in the correct dosage (based on age and weight), but no more than 4 times in 24 hours.
• Ibuprofen may be given from 3 months of age, every 6 to 8 hours in the correct dosage (based on age and weight), but no more than 3 times in 24 hours. If your child has a bleeding disorder, do not give them ibuprofen.
• Never give your child aspirin, unless specifically instructed by your doctor.

It’s important to make sure that you give your child the correct dose of pain medicines for the shortest period possible. Read the instructions on the pack carefully, as the amount your baby needs will be specific to your baby’s age and weight, and the strength of the formulation you buy. Giving your child too much medicine or giving it too frequently could be harmful.

Where can I get help?

Any baby or young child who is unwell or in moderate to severe pain should see a doctor to determine the source of the pain.

Do not give your baby or child paracetamol or ibuprofen for more than 48 hours without seeing a doctor.

Ask your pharmacist if you are unsure of the correct dose of medicine for your baby.

Speak to a maternal child health nurse

Call Pregnancy, Birth and Baby to speak to a maternal child health nurse on 1800 882 436 or video call. Available 7am to midnight (AET), 7 days a week.

Sources:

Royal Children\u2019s Hospital
(Neonatal Pain Assessment),
Government of South Australia
(Post-natal care),
Miracle Babies foundation
(Miracle Babies foundation),
Royal Children\u2019s Hospital
(Sucrose (oral) for procedural pain management in infants),
Royal Children’s Hospital Melbourne
(Pain relief for children – paracetamol and ibuprofen)

Learn more here about the development and quality assurance of healthdirect content.

Last reviewed: November 2022

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How are children treated when they are in pain?

author: Dipl. -Biol. Maria Yiallouros, Erstellt am 2019/03/19, editor: Maria Yiallouros, Print permission: Prof. Dr. med. Dr. h.c. Günter Henze, Translator: Dr. Natalie Kharina-Welke, Last modified: 2019/03/19

https://kinderkrebsinfo.de/doi/e67771

Table of contents

1. When can the pain begin?
2. How is pain determined?
3. How are children treated for pain in pediatric oncology?

Almost all children with cancer have pain that comes from the disease or from treatment. How strong these pains are and how long they remain depends on the specific individual situation.

When does the pain start?

Pain (such as headache) can be a symptom of the disease itself, i.e. cancer. But pain can also appear at a time when the child is undergoing treatment. For example, when certain types of diagnostics are done, or at certain stages of treatment (bone marrow puncture‎, or lumbar puncture‎). Pain can be a side effect/complication after chemotherapy [chemotherapy‎] and radiation therapy [radiotherapy‎] (i. e. it occurs when, for example, the mucous membranes become inflamed when the child has an infection [infection‎], this may be one of the reactions organism for irradiation). But even after the treatment is over, children and adolescents may experience pain. These pains are a distant complication of cancer or anti-cancer treatment.

Pain is one of the main problems in children with cancer.

How is pain determined?

Understanding how severe the pain is can be very difficult for the patient himself, and for his family, and for the doctors themselves. But it is this criterion that makes it possible to choose the most effective analgesic treatment. To assess the severity of pain in children, specialists choose different methods, which depend on the age of the sick child:

Infants and young children , for example, cannot report pain at all. But they have strange behaviors that can be used to assess how much pain bothers the child. For example, children begin to scream / cry, become restless, their sleep is disturbed, inadequate facial expressions appear, they begin to eat less or play less. Therefore, the pain assessment algorithm is based on careful observation of these changes.

older children and adolescents have the opportunity to ask where exactly it hurts and how it hurts, how often the pains begin. In doing so, the so-called “pain assessment questionnaires” have become a valuable aid. With their help, children, adolescents and / or their parents themselves can describe pain, focusing on a specially designed scale to determine the intensity of pain.

How are children treated for pain in pediatric oncology?

What kind of pain relief treatment will be depends on the specific situation. It could be medication. Non-drug treatments can also help.

Medical pain relief treatment

Methods of medical analgesic treatment include the use of painkillers (analgesics). They are given either in tablet form or administered intravenously. What kind of pain medication will be given depends on what kind of pain the child has, why they appeared and how intense they are. Sometimes ordinary painkillers, such as those used for headaches, or toothaches (such as paracetamol), are sufficient for treatment. But most often one has to resort to more potent drugs, for example, when it is necessary to treat complications on the oral mucosa (and they can be quite strong) arising from the anti-cancer treatment itself.

If the pains are very strong, for a certain time, not very long, it is necessary to treat them with opiates, for example, morphine. At the same time, so that the child does not develop physical dependence, the drug is administered intravenously through a special infusion pump for the administration of pain medications. With the help of such a pump, the patient can inject the drug himself by pressing the dispenser button when he has pain. Doctors program their dose and quantity for each. They are limited and at the same time the consumption / consumption of the drug is controlled. Treatment is built for each child individually. The main goal is that the child does not have pain.

When the bone marrow is taken for a puncture, children often perceive this procedure as painful. Therefore, such a practice has proven itself when children are punctured under short anesthesia. And thus, children do not have fear of the procedure, stress and pain.

How can pain be eliminated by non-drug methods?

Drug treatment of pain is complemented by various methods and techniques that help reduce pain. These include:

• techniques from behavioral psychotherapy (e.g. breathing technique, i.e. breathing exercises; exercises for deep muscle relaxation, professionally called “progressive muscle relaxation”)
• Cognitive psychology techniques (e.g. distract from pain with music or play; hypnosis; influence child through comfort and support)
• physical methods (for example, such touching or physical contact techniques as stroking a child, holding him, massaging him, rocking a child). The mere presence of loved ones can greatly reduce the pain.

Non-pharmacological techniques and techniques are an integral part of the treatment plan for children with cancer.

Main literature:

1. Zernikow B: Schmerztherapie in der Kinderhämatonkologie, in Zernikow B: Schmerztherapie bei Kindern. Springer Medizin Verlag Heidelberg 3. Aufl. 2005, 217 [ISBN: 3-540-23728-3]
   ZER2005
2. Zernikow B: STOP dem Schmerz – Schmerz-Therapie in der Onkologischen Pädiatrie (STOP) – Ergebnisse eines bundesweiten Qualitätsmanagement-Programms. WIR Informationsschrift der Aktion für krebskranke Kinder e.V. (Bonn) 2004, 4:19[URI: http://www.kinderkrebsstiftung.de/ fileadmin/ KKS/ files/ zeitschriftWIR/ 2004_4/ stopdenSchmerz.pdf]
   ZER2004

Anesthesia for children – GALA DENT

We, dentists, especially CHILDREN’S, are responsible for the health of the child here and now, and we must think about his future health. It depends on us what attitude a person will have towards a dentist, and towards all doctors in general. It is the responsibility of the parents to help the child learn how to properly treat their health and seek help in a timely manner.

Pain is the factor that creates fear. If a child was deceived at least once: they said that treating teeth did not hurt, but at the reception he experienced pain, trust in the dentist and parents in this matter will end forever. Therefore, it is IMPOSSIBLE to treat children’s teeth WITHOUT anesthesia. If an adult responds even more or less normally to discomfort during treatment, then for a child such a situation is scary and incomprehensible.

Does the child have a toothache?

This is a real question parents often ask. Yes, children’s teeth hurt, and sometimes more so than adults. Also, it’s much scarier for a child. Therefore, any treatment with minimal preparation, and even brushing teeth in the dentist’s office, should be carried out with the use of anesthetics.

Modern anesthesia techniques and types of drugs help the pediatric dentist to effectively treat children without pain and stress, and at the same time in a completely safe way. How to do it? This article is about this.

What is the difference between pediatric and adult anesthesia?

Features of pediatric anesthesia are determined by the characteristics of the child’s body.

For example, a child’s body needs 2 times more oxygen than an adult. Also, the children’s body is characterized by a rapid change in physiological conditions and an increased ability to adapt. At the same time, children are more sensitive to changes in environmental temperature, have increased emotionality, it is difficult for them to stay in one position for a long time. There is a high probability in children and allergic reactions, and the smaller the child, the more careful you need to choose the drug.

Therefore, when conducting pediatric anesthesia, the following rules must be observed:

Accurately select the anesthetic drug and its dose. There is some difficulty in anaesthetizing children under 4 years of age, because most local anesthetics are used from the age of 4. For a child prone to allergies, it is better to conduct special allergy tests in order to know exactly which drug is safe for him.

The child should be administered the anesthetic in the most gentle way possible. Children are often afraid of tools, and even more so of syringes. Before the injection, the injection site should be treated with a tasty anesthetic gel that “freezes” the gums. A large selection of such drugs is available today.

Due to the increased susceptibility to ambient temperature, the child may be cold during treatment in a cool room, or vice versa – hot if the room is poorly ventilated and too small. This factor must be taken into account.

Do not neglect the method of premedication before visiting the dentist. Taking a sedative medication will help your child relax and be less afraid.

A very important component is the doctor’s personality. A good pediatric dentist finds an approach to parents and to the child and turns fear into interest. Advice to parents: help him with this to the best of your ability.

What types of anesthesia are used in pediatric dentistry?

Application anesthesia gel with anesthetic.

This is the most “not scary” method of pain relief for a child, but also the weakest. It is enough to perform professional hygiene, remove a loose tooth or “freeze” the injection site. But its use should not be underestimated.

Classic injectable local anesthesia.

Mainly used from about 4 years of age, but has few contraindications. The main thing is to find out if the child has an allergy to the proposed drug. The dentist chooses the type of anesthetic substance based on the child’s age, condition, and even mood. Articaine preparations are widely used for anesthesia of dental treatment in children – its action is 5 times stronger than novocaine familiar to us, it is non-toxic and does not provoke allergic reactions.

General anesthesia is a treatment under anesthesia.

It is often possible to meet the desire of parents to treat their child’s teeth under anesthesia. It’s easier for parents and a doctor, but for a child?

Two strict rules for the use of anesthesia in pediatric dentistry:

• Anesthesia is NOT USED unless there are very good reasons.
• Treatment under anesthesia is possible ONLY in rooms specially equipped for this purpose, where there is a complete set of equipment for resuscitation, and there is an anesthesiologist and resuscitator on staff. Or such equipment can be deployed by a mobile anesthesia team.

Indications for dental treatment in a child under anesthesia:

• Age up to 4 years.
• Developmental features: autism, Down syndrome, cerebral palsy or epilepsy.
• Large volume of dental intervention.
• Allergy to local anesthetics.

Extreme overwhelming fear of treatment, in case other methods have been tried and have not worked.

4. Sedation

   Sedation is not pain relief in the classical sense. This is a relatively new method in which a small patient breathes a mixture of nitrous oxide – “laughing” gas, and oxygen. This method has a good relaxing effect, the child calms down, plunging into a superficial sleep, but can answer questions and remains conscious. Sedation goes well with local injection anesthesia.

What is premedication and when is it needed?

Premedication is the use of special sedatives in advance of a visit to the dentist. It is also effective in children, so we draw the attention of parents to this method of relieving attacks of fear.

Pain has 4 factors:

• sensory sensitivity is the physical cause of pain,
• psycho-emotional state of the patient,
• autonomic component due to overload of the autonomic nervous system,
• motor component.

That is, the more a child is afraid, rushes about and is in a state of stress (mobilization of the autonomic nervous system), the more painful it is for him. If you see that persuasion, stories and other tricks do not work on the child, then it is better to use medication than to cause irreparable harm to the child’s psyche.

It is best to discuss with your pediatrician which sedatives are appropriate in this situation.
From safe home remedies, you should try a decoction of valerian roots or motherwort. You need to drink it 1-3 days before going to the dentist in accordance with the doctor’s instructions, according to the age of the child.

How anesthesia is done for children in the GALA DENT clinic

Small patients of the GALA DENT clinic in Prosvet have access to application and local injection anesthesia. The choice of anesthetic is made by a pediatrician based on the results of anamnesis in a conversation with parents. If necessary, we refer the patient to an allergy test. A big request to parents: please fill out the child’s “Health Sheet” very carefully before admission.

We always give an injection of an anesthetic to a child with local application anesthesia, so that he does not even feel the injection itself.

And a little advice from our practice, in order to minimize the stress of a child from a visit to the dentist for treatment, come with him for the first time to a preventive appointment, where he will not be treated for teeth, to get acquainted with the clinic and the doctor.

Still have questions?

Book your child for a consultation with our specialists and enjoy all the benefits of treatment at the GALA DENT clinic.

FAQ

How to treat teeth if a child has an allergy?

Answer:
Allergic reactions are much more common in children than in adults. Any new substance can cause an allergy. Therefore, before the first anesthesia, it is better to take tests and find out which substances will be safe for the child. How to do this – the doctor will tell you. It is worth remembering the drug that is suitable for the child and, if possible, use it in the future.

Is anesthesia possible for children under 4 years of age?

Answer:
Yes. At this age, anesthesia is often used for major dental interventions. At the same time, it is necessary to evaluate what is more dangerous: the consequences of anesthesia or not treated. For children under 3 years of age, conservative treatment, prophylaxis and professional hygiene under topical anesthesia are recommended, if necessary.

After 3 years, local injection anesthesia can be used to a limited extent with an accurate calculation of the dose of anesthetic according to body weight. There are no direct contraindications to this, but the effect of painkillers at an early age has not yet been fully studied.

Why does the child injure the mucosa after anesthesia?

Answer:
The child feels the action of the anesthetic in the same way as an adult – part of the gum and tongue become numb. Having experienced such a sensation for the first time, the child may not calculate the movement of the jaw to injure himself. The dentist will definitely warn parents and the baby that you need to be careful. It is advisable not to give the child food for 2-3 hours after treatment, and it is better to drink water through a straw.

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The cost of pediatric anesthesia in the clinic “GALA DENT”

Consultation of a specialist doctor500 ₽

Additional services

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The most important thing read

• Child, same as an adult feels a toothache, so it is necessary to treat children’s teeth with anesthesia.

• The child’s body has a number of physiological features that must be taken into account when performing anesthesia. One of the main ones is the tendency to allergic reactions.

• The dose of anesthetic for a child is always calculated according to age, body weight and depth of intervention.

• For pain relief of dental treatment in children, application, local injection anesthesia, sedation and, in some cases, anesthesia are used.