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Parents Can Play Major Role Although progress has been made in understanding pain in infants and children, these youngest patients do not always receive the pain control they need, according to an article in a special pain management issue of the Journal of the American Medical Association. An analysis of original research studies and reviews from 1966 to 2003, found that chronic pain is far more common in children than previously thought and that the experience of pain in early life may have long-term consequences. The most common type of pain in children is acute or short-term pain caused by injury, illness or medical procedures. Long-term or chronic pain, however, may affect as many as 20% of children, according to the National Pain Foundation, and may predispose these children to have ongoing pain as adults. Pain can also disrupt treatment, slow healing and cause additional me-dical problems. Newer Medications Have Less Severe Side Effects Contributing to the undertreatment of pain are beliefs by some that children, particularly infants, do not feel pain the same way adults do and that pain builds character in children, as well as fears about the side effects of pain medications. Over the years, how-ever, physicians and other health professionals have gained valuable experience in administering medications that can control pain without inducing constant drowsiness and/or drug de-pendence. Because managing pain often relies on the patient’s own evaluation of pain, children, especially younger children, are at a disadvantage. Parents, therefore, are being increasingly recognized as important participants in pain management for their children. Better communication between parents and healthcare professionals can also improve pain management. The Medical Society of the State of New York endorses a joint policy state-ment from the American Academy of Pediatrics and the American Pain Society that stresses the need for health care professionals to eliminate or ease pain suffered by children whenever possible. The state ment also calls for involving families in creating solutions Continued on page 46 for their child’s pain. Parents Know Best How to Comfort Their Own Children Pain that is untreated can make children afraid, anxious, depressed, irritable and tired. Uncontrolled pain can also cause children to have trouble eating and sleeping and to revert to immature, babyish behaviors. When children are too young, too sick or too afraid to say how much pain they have, parents are usually the next best judges. Parents know best how to comfort their own children and can talk to the children’s doctor about pain management. A pamphlet published by the Asso-ciation for the Care of Children’s Health (ACCH), a group based in Canada, provides information on how parents can help children deal with pain. The pamphlet can be accessed on the Internet at www.dal.ca/~pedpain. The Medical Society of the State of New York recommends the following advice, which was adapted from the ACCH booklet. Just having a parent or other loved one present may be the best psychological treatment for pain. Generally, a parent should accompany children who need to undergo medical procedures. Touch is important, especially for younger children. Depending on the illness or injury and the type and extent of pain, holding, cuddling, massaging or gently rocking children can be comforting. Like other patients, children want and need information about what is going to happen to them. Parents can ease fears by explaining, in language that their child can understand, what procedures are going to be done and how the child might feel during and after a particular procedure. Parents can also encourage children to ask questions and express their feelings. Letting a child have some control over treatment, such as sitting or lying down to receive an injection, usually helps to reduce pain. Teaching children deep and steady breathing can help children gain a feel-ing of self control and may help to ease fear, tension and pain. For additional information about pain management, visit the National Pain Foundation website at http:// wwwpainconnection.org/ or the American Academy of Pain Medicine website at http://www.painmed.org/. This information is provided by the Medical Society of the State of New York (MSSNY).
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