By Nina Gonzalez, MD, co-founder of Hello Brave
As both a doctor and a mom, I understand the profound anxiety that can accompany a child’s medical procedure. I still remember the many doctors appointments in my boys’ first year, and all of the shots they endured. Watching my babies experience pain was heart wrenching, and I always thought, I wish it could be me getting that needle instead of you. All I wanted to do was take their pain away.
After the first couple appointments, I started looking into the research on pain management for children undergoing medical procedures. I was both delighted and surprised to find quite a bit of research and techniques that could help. Delighted of course because now I had some tools to help me help my children. Surprised because, 1. Why hadn’t I learned about this in medical school? And 2. Why didn’t my children’s providers offer up this information or utilize the strategies I read about?
The truth is that many medical professionals do not get properly trained on pain management techniques. There is a lot of learning to pack into the four years of medical school and additional years of residency, and sometimes the most practical information gets missed. This highlights the importance of patient education and becoming an advocate for your children. As the saying goes, knowledge is power. That is why I’ve summarized some of the research I discovered here, so that you may also feel more confidence in knowing how to help your child through potentially painful medical experiences.
That said, this blog is just an introduction to these topics. For a really in-depth and well done resource on children’s pain management, I recommend checking out all the amazing work put out by the Meg Foundation. They’ve created some truly accessible resources for kids and adults alike, and they offer information about strategies for pain reduction in an easy to follow and engaging way.
For this post, I’ll give an intro on the science of pain and some evidence-based pain reduction techniques and tips for parents.
Why Does it Hurt? The Science of Pain in Children
Pain is a complex experience influenced by biological, psychological, and social factors. In children, pain perception can be heightened due to their developing nervous systems and limited coping mechanisms. Here’s a closer look at how pain works:
Biological Factors: Pain signals are transmitted through the nervous system to the brain, where they are processed and perceived. Children’s nervous systems are still developing, which can affect how they experience and express pain.
Psychological Factors: Anxiety, fear, and previous negative experiences can amplify pain perception. Children who are anxious about a procedure may report higher pain levels.
Social Factors: The presence of a parent or caregiver, the behavior of healthcare providers, and the overall environment can influence a child’s pain experience. A supportive and calming presence can significantly reduce perceived pain.
What Can I Do? Evidence-Based Pain Reduction Techniques
Research has identified several effective pain reduction techniques for children undergoing medical procedures. Here are some of the most effective strategies:
Distraction Techniques: Engaging a child’s attention away from the procedure can reduce pain perception. Techniques include:
Visual Distractions: Watching videos, looking at picture books, or using virtual reality.
Auditory Distractions: Listening to music or engaging in conversation.
Interactive Distractions: Playing with toys or games.
Cognitive-Behavioral Techniques: Helping children manage their thoughts and emotions can lessen their pain experience.
Breathing Exercises: Encouraging deep, slow breathing to promote relaxation.
Guided Imagery: Leading the child to imagine a peaceful and safe place.
Positive Reinforcement: Offering praise or rewards for bravery and cooperation.
Physical Techniques: These methods can directly reduce the sensation of pain.
Topical Anesthetics: Applying numbing creams or gels to the skin before needle procedures.
Vibration Therapy: Innovative products like BUZZY use vibration to stimulate the body's natural "gate control" pain relief system to confuse nerves and dull or eliminate sharp pain.
Cold and Heat Therapy: Using cold packs or warm blankets to soothe the area.
Comfort Positioning: Holding the child in a comforting position to reduce fear and physical discomfort. This resource developed by Child Life on Call and Meg Foundation has several examples of effective comfort positions.
Strategies for Parents
As a parent, you play a crucial role in managing your child’s pain during medical procedures. Here are some practical strategies:
Prepare Your Child: Knowing what to expect can take away much of the anxiety related to medical procedures. Explain the procedure in age-appropriate language. Use books, videos, or role-playing to help them understand what to expect.
Stay Calm and Supportive: Your child will look to you for cues on how to react. Remaining calm and reassuring can help reduce their anxiety.
Use Pain Reduction Techniques: Try the techniques mentioned above that you think will work best for your child.
Advocate for Your Child: Speak with healthcare providers about your child’s pain management needs. Request the use of topical anesthetics or other pain-reducing measures.
The Bottom Line
Navigating medical procedures with your child can be challenging, but understanding the science of pain and utilizing evidence-based pain reduction techniques can make a significant difference. By preparing your child, staying calm, and using effective strategies, you can help ease their pain and anxiety, making the experience more manageable for both of you. Remember, you are your child’s best advocate and source of comfort.
References
Krauss BS, Calligaris L, Green SM, Barbi E. Current concepts in management of pain in children in the emergency department. Lancet 2016;387(10013):83–92.
Stevens BJ, Abbott LK, Yamada J, et al.; CIHR Team in Children’s Pain. Epidemiology and management of painful procedures in children in Canadian hospitals. CMAJ 2011;183(7):E403–10.
Stevens B, Yamada J, Ohlsson A, Haliburton S, Shorkey A. Sucrose for analgesia in newborn infants undergoing painful procedures. Cochrane Database Syst Rev 2016;7:CD001069.
Trottier, Evelyne D., et al. "Managing pain and distress in children undergoing brief diagnostic and therapeutic procedures." Paediatrics & child health 24.8 (2019): 509-521.
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