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How to know when a child is in pain
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HealthWiki > Helping Children Live with HIV > Chapter 13: Helping children with pain > How to know when a child is in pain
Children show they are in pain in many ways. Some are easier to see and understand than others. But you know your child, and if you watch and listen closely and think of how your child usually behaves, you can often tell when something is wrong.
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| Some types of pain are sharp, sudden, and caused by something easy to see and understand | Some pains are caused by things you cannot see, such as joint pain or headaches. These can be just as hard on a child as a bad cut, especially if they are long-lasting. |
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Common signs of pain in children
Because children are not always able to describe or tell us about pain, we have to watch for signs.
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 It hurts, mama! |
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Signs in babies
Look for crying and signs of distress on the baby’s face or in how he holds his body. He may tap his head if it hurts.
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| A child in extreme pain may hold her whole body very stiff and still, or strongly arch her back. |
Pain may also cause a baby to tense her legs, either kicking them out or drawing them up towards her chest. Or if pain is very strong, it may make a baby move around a lot.
If your baby is crying and you know he is not hungry, wet, or tired, think about whether he might be in pain. Crying that sounds different from usual may be a sign of pain.
Signs in young children
Children old enough to talk or play have more ways to show you they are in pain. Sometimes children show you by how they play.
A child in pain may pull away or cry out when you touch him. You may think he does not want you near, but he will usually stay near enough so he is not left alone.
Children can also have pain and show no signs, especially if they are very weak, or have had pain for some time and have grown used to it.
How to talk with young children about their pain
If your child is old enough to talk, you can ask her to tell you about her pain. Sit at the child’s level and be gentle and patient. A child in pain may need more time and help to answer questions.
It may help to ask about pain in different ways:
 Is it a little or a lot?
Is it sharp or more like squeezing? |
 What makes it worse? What makes it better? |
 Point on the doll to where it hurts on you. |
Children older than age 5 may be able to use a simple pain scale. Say how much pain it means as you hold up different numbers of fingers. Then ask the child how many fingers best describes the pain he feels. But even adults have problems describing their pain, so do not rely on this alone — watch and talk with the child.
Believe a child when she says she has pain. No one wants a child to hurt, so sometimes we want to believe a child is not really in pain. In fact, many children try to hide pain to stop you from worrying. Or they may want to avoid medicines or an injection. Also, if a child thinks pain is a punishment for doing something “bad,” she may try to hide it so you will not know she was “bad.”
When talking to a young child, look for signs of pain and discomfort. Keep in mind that children in constant pain sometimes stop showing their pain much, and do not know how much they are hurting or how to describe their pain.
If you are a health worker, ask the child’s mother or other caregivers how the child has been acting, what he is like when he is not sick, and how they think he feels.
When you first meet a sick child, get to know him a bit before you ask about pain. See Chapter 4: Communicating with children.
It may help to watch your child for signs of pain when she is playing or talking with another person — she may show her pain differently