Managing pain: Helping your child feel better

Children feel pain in much the same way as adults, but are usually a lot more vocal about it! As you’ve no doubt experienced, it can sometimes be very tricky to figure out what’s causing your child’s grumps or grumbles – as for example, a ‘sore head’ can mean anything from earache to headache to teething pain or a sore throat.

Older children can usually tell you what is wrong, but babies and very young children can’t show you where and how much it hurts, except by crying or screaming. If your baby is crying for no apparent reason, monitor him or her closely for anything that seems unusual to you.

Mild pain can be managed at home with paracetamol such as Pamol^®, but moderate to severe pain may need to be checked out by a doctor¹. Even if your child doesn’t have any other symptoms of illness, trust your instincts and head to a doctor if you’re at all concerned.

For young babies and toddlers, this handy ‘pain scale’ illustration can help you figure out just how ouchie your child is feeling:

Pamol pain scale

^{Adapted from Hicks C.L. et al. Pain. 2001; 93(2):173-83)}

How much medicine and how often?

Paracetamol is the recommended first-line treatment for pain and fever in children². However, when you’re giving any medicine to children, it’s crucial to get the dose right, as too much may cause damage to their developing organs². So before giving any medicine (even if you’ve used it before), remember to:

• Always check the pack to ensure you’re giving the right dose for your child’s age and weight.
• Check the active ingredient to see if it’s appropriate to give to your child.
• Make sure your child is not taking any other medicines (over-the-counter or prescription) that contain the same ingredients, or may interact with the medicine you’re giving.
• Give paracetamol no more than four hourly, and no more than four doses in 24 hours³.
• Measure the dose accurately – a dosing syringe from your pharmacy is best. Ask your pharmacist if you are not sure about how to measure a dose.
• Follow any pack directions about use and storage eg shake the bottle to ensure the medicine is dispersed evenly. Store medicines safely out of reach of children and at the recommended temperature (usually in a cool place below 25 deg C and away from direct light).
• Your child may be dehydrated because of their illness, so make sure they’re drinking enough fluids.
• Don’t give ibuprofen and paracetamol at the same time. It is not recommended without a doctor’s advice³

What is the right age to switch your child to paracetamol tablets instead of liquid medicines?

Most kids can swallow tablets by around twelve years old, and some children can swallow tablets from a younger age. However, that doesn’t mean that you should automatically switch your child from liquid paracetamol to tablets, as a 500mg tablet may be too much medicine for a smaller child and may cause liver damage⁴.

A liquid medicine offers better dosing flexibility as you can accurately measure just the right amount of medicine for your child.

When to switch obviously depends on the willingness or ability of your child to swallow tablets! However, if you’re not sure, it’s a good idea to talk with your doctor or pharmacist first.

References: 1. www.kidshealth.org.nz guidelines, endorsed by the Paediatric Society of NZ, accessed 11 Sep 2014. 2. Avoiding medication errors in children: a practical guide for healthcare professionals. BPJ issue 29, Jul 2010. 3. Non-steroidal Anti-inflammatory Drugs (NSAIDs): making safer choices. BPJ Issue 55, Oct 2013. 4. New Zealand Formulary for Children 1 Feb 2014

PAMOL^® for the treatment of child pain and fever. Always read the label and use as directed. Incorrect use can be harmful. If symptoms persist see your healthcare professional. ® Registered Trademark. Aspen Pharmacare C/- Healthcare Logistics, Auckland, TAPS PP5776

This post was sponsored by PAMOL^®.