Pain relief for babies under 2 months
Pain management in babies | Pregnancy Birth and Baby
Pain management in babies | Pregnancy Birth and Baby beginning of content4-minute read
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Healthy babies will, at times, experience pain during events that are a normal part of growth and development, including teething pain, blood tests and vaccinations. A baby may also experience pain due to illness or injury. Just like adults, each baby’s reaction to pain is different, but unlike adults, babies can’t tell you how they are feeling, so they rely on you to recognise their pain and help them through it.
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 unclear 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.
Common pain
In the first year of life, your baby will undergo several 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 premature, or with a medical problem, they may also require blood tests, feeding tubes, IV lines or surgery to help them perform all the tasks our bodies do naturally. 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 your very presence may have a calming effect.
Some established pain-reducing techniques include:
- letting your baby hold your finger
- talking or singing to your baby
- swaddling your baby in the fetal position
- breastfeeding
- nappy changing
- offering them a dummy
- tactile soothing (stroking the head and back softly)
- 'kangaroo care' (skin-to-skin contact between parent and child, both covered by a blanket)
- holding your baby with both hands (to provide a feeling of security)
- taking your baby to a dark, quiet space
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 sugar (sucrose) solution. These techniques are proven to have a calming and pain-relieving effect on infants.
Video provided by Sharing Knowledge About Immunisation.
When can I give pain medicine?
You can give your child medicines such as paracetamol and ibuprofen for short-term relief of fever-like symptoms. While they won’t make the cause of the pain go away, they will make your baby feel and sleep better.
- Paracetamol may be taken 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 taken 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 newborn aspirin, unless specifically instructed by your doctor.
Where to get help
If your newborn has been taking paracetamol or ibuprofen for 48 hours but is still unwell, seek medical advice.
Ask your pharmacist if you are unsure of the correct dose of medicine for your baby.
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.
Sources:
Raising Children Network (Immunisation in childhood), The Royal Children's Hospital Melbourne (Pain relief for children - paracetamol and ibuprofen), Royal Children’s Hospital (Neonatal Pain Assessment), International Association for the Study of Pain (Pain management in children), Better Health Channel (Pain management (acute) - children), SA Health (Too small too soon), Frontiers in Psychology (Pain, Parental Involvement, and Oxytocin in the Neonatal Intensive Care Unit), Royal Children’s Hospital (Sucrose (oral) for procedural pain management in infants)Learn more here about the development and quality assurance of healthdirect content.
Last reviewed: August 2020
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Related pages
- Helping kids with medical procedures
- Breastfeeding your baby
- Immunisation and vaccinations for your child
- What is kangaroo care?
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Medicines for babies and children
Medicines are not always needed for minor illnesses like coughs and colds in children.
If your child does need a medicine, it's important they have one that's right for their age and you know how to give it to them safely.
Paracetamol and ibuprofen for babies and children
Paracetamol and ibuprofen are safe for treating pain and a high temperature in babies and children. Both are available as liquid medicines for young children.
It's best to choose a sugar-free version. Medicines that contain sugar can harm your child's teeth.
Make sure you get the right strength for your child's age and check the label for the correct dose. Or you can ask a pharmacist for advice.
It's a good idea to keep one or both medicines stored in a safe place at home.
At what age can I give my baby paracetamol or ibuprofen?
You can give paracetamol to children aged 2 months or older for pain or fever.
You can give ibuprofen to children who are aged 3 months or older and who weigh more than 5kg (11lb).
If your child has asthma, get advice from a GP or pharmacist before giving them ibuprofen.
Do not give aspirin to children under 16 unless it's prescribed by a doctor. It's been linked with a rare but dangerous illness called Reye's syndrome.
If you're breastfeeding, ask your health visitor, midwife or GP for advice before taking aspirin.
Read more about breastfeeding and medicines
Antibiotics for children
Children do not often need antibiotics. Most childhood infections are caused by viruses. Antibiotics only treat illnesses caused by bacteria, not viruses.
If your child is prescribed antibiotics for a bacterial infection, they may seem better after 2 or 3 days. But it's important to always finish the whole course to make sure all the bacteria are killed off.
If you do not finish the whole course, the infection is more likely to come back. It also increases the risk of the bacteria becoming resistant to antibiotics.
Antibiotics work best if they are given at regular intervals. Giving them to your child at the same times each day may help you to remember.
Giving medicine to your child
Credit:
DR P. MARAZZI/SCIENCE PHOTO LIBRARY https://www.sciencephoto.com/media/686975/view
Make sure you know how much and how often to give a medicine. Recording it in your child's Personal Child Health Record (PCHR, or red book) may help you remember.
Always read the label on the bottle, and stick to the recommended dose. If in doubt, check with a pharmacist, health visitor or GP.
Most medicines for young children come with a special measure called an oral syringe.
This helps you measure small doses of medicine more accurately. It also makes it easier to give the medicine to your child.
If you're not sure, your health visitor or pharmacist can explain how to use the syringe.
Never use a kitchen teaspoon to give your baby or child medicine, because they come in different sizes.
Video: how to give medicine to a child using an oral syringe
This video describes how to give medicine to a child using an oral syringe.
Media last reviewed: 17 July 2022
Media review due: 17 July 2025
The leaflet that comes with a medicine will list any possible side effects.
If you think your child is reacting to a medicine – for example, with a rash or diarrhoea – speak to a GP, health visitor or pharmacist. In the evenings or at weekends you can call NHS 111.
Keep a note of the medicine's name in your child's red book for future reference.
Can you get over-the-counter children's medicines for free?Some pharmacies run what's known as a minor ailment scheme for specific ailments, such as coughs and colds and diarrhoea and vomiting.
When pharmacies provide medicines as part of a minor ailment scheme, you get the medicines on the NHS. You will not pay a prescription charge for children under 16.
Not all pharmacies offer a minor ailment scheme, and the ailments covered by the scheme vary from area to area.
Children's medicine safety tips- Always check the expiry date – if you have any medicines at home that are out of date or your child no longer needs them, take them to a pharmacist to dispose of safely.
- Never give your child medicines that have been bought or prescribed for someone else.
- Always keep medicines out of your child's reach and out of sight.
- Ask a pharmacist about storing the medicine – some need to be kept in the fridge or out of direct sunlight.
Page last reviewed: 15 February 2021
Next review due: 15 February 2024
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nine0215
When we talk about pain relief in children, parents only need to remember two names: paracetamol and ibuprofen
Both of these drugs are very well studied, approved for use in childhood, sold without a prescription. Let's consider them separately.
Paracetamol has an antipyretic, analgesic effect. Approved for use from 2 months of age. Dosage of 15 milligrams per kilogram of body weight, no more than 4 times a day. The duration of action is 4-6 hours. nine0215
Ibuprofen , in addition to its antipyretic and analgesic effect, also has an anti-inflammatory effect, which makes it more effective for pain caused by an obvious inflammatory process, swelling, bruises and injuries. Approved for use in children from three months. Dosage 10 milligrams per kilogram of body weight, no more than 3 times a day. The duration of action is 6-8 hours.
A few points of clarification:
- These preparations are represented by numerous trade names in pharmacies. They come in the form of a suspension, soluble tablets, suppositories, coated tablets, capsules. In children under 6 years of age, a suspension or soluble tablet form is used; over six, if the child can swallow, coated tablets or capsules can be used. Candles are used when it is impossible to give the drug through the mouth. For example, a child vomits or he refuses to drink medicine in principle. There is no evidence that suppositories are more effective than oral forms. nine0008
- Follow the recommended dosage carefully. If the instructions say no more than 4 times a day, this means no more than 4 times in 24 hours, and not per day. To calculate the required single dose, you need to multiply 15 mg for paracetamol or 10 mg for ibuprofen by the weight of the child in kilograms. For example, the weight of a child is 8200 grams, we multiply 15 by 8, we get 120 mg for paracetamol, or 10 by 8, we get 80 mg for ibuprofen. This is the dose that can be given at one time, no more than 4 times a day for paracetamol, and no more than 3 times for ibuprofen. Once again, first of all, we focus on weight, and not on age, since one child at 8 months weighs 8 kilograms, and the other 11, respectively, the dose for them will be different. Also, do not try to give a smaller dose. This will only lead to the fact that the drug will not work, or will act for a shorter time. nine0008
- Combination formulations of ibuprofen and paracetamol. I know many parents love these drugs. But meanwhile, there are studies that indicate that the combined form of the drug has no advantages in strength, speed of onset of the effect and its duration. However, there is a higher risk of side effects. In addition, with such drugs it is more difficult to calculate and comply with the correct dose and frequency of use. Using ibuprofen and paracetamol separately, you can alternate them, and if necessary, give antipyretic, painkillers up to 7 times a day in total. nine0008
When can these pain medications be used?
It is logical when something hurts. For headache, toothache. When a child has a sore ear or throat. With bruises, injuries, wounds, sprains. With bites of animals, insects. There is a rule, if something hurts - anesthesia. The only, somewhat controversial point is the pain in the abdomen. In this case, almost all Russian recommendations, examination and treatment protocols do not recommend taking painkillers before making a diagnosis, so as not to “lubricate” the symptoms and delay the diagnosis. At the same time, in foreign recommendations, on the contrary, it is often stated that there is no need to endure pain, and taking such drugs does not lead to a later diagnosis. In my opinion, with mild abdominal pain, it is acceptable to distract the child with something without taking medication and watch him for several hours. If the pain persists or is initially pronounced, then it is worthwhile to consult a doctor as soon as possible and decide with him, including the issue of anesthesia. nine0215
Make an appointment with a pediatrician
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Tags Pain relief Pediatrician
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
Contents
- When can the pains start?
- How is pain determined?
- 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. nine0252
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. nine0252
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. nine0252
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. nine0252
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. nine0252
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, methods of such touching or such physical contact as stroking a child, holding him, massaging him, rocking a child).