Pain relief in children
It’s difficult to see your child in pain with an earache, toothache, or sore throat, and your instinct is to take that pain away naturally. You can try certain things at home, and we’ll talk you through how to increase pain relief as needed. But bear in mind that pain has a function: it alerts us that something is wrong.
Your child may not be able to articulate how they feel or exactly where the pain is, so if they seem in significant pain or it’s going on for more than a few hours, if you’re unsure of the cause, or if they have other symptoms, don’t hesitate to seek a medical opinion. This is especially true for tummy pain, a headache, or hip pain.
What can you find here?
What should I try first?
Acetaminophen is usually a good place to start. It can relieve both pain and fever. It comes in several formulations specifically designed for children. Follow the dosing instructions carefully.
Ibuprofen is another commonly used medication that treats both fever and pain. It has the added benefit of also being anti-inflammatory. Follow the dosage guidelines carefully on those products that are designed to be used in children.
What should I try next?
If acetaminophen or ibuprofen alone have not helped, you can try combining them. Alternating them is best, so you’re giving something every 2 to 3 hours. You may need to keep a diary to keep track of what they’ve had and when to avoid over or under-dosing them.
This is quite a lot of pain relief for a child, so even if you feel confident of the cause, if you have to give this for 24 to 48 hours, it’s worth getting advice from a doctor. Don't hesitate to seek advice sooner if you have any reason to doubt the cause or the right way forward.
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Should I avoid any medications?
If your baby or child hasn't had ibuprofen before and is diagnosed with asthma, this can bring on difficulty in breathing, called bronchospasm. Avoid it if they are asthmatic and haven't tried it before or it has caused problems. Seek urgent medical attention if they are having breathing problems.
Ibuprofen can also irritate the lining of the stomach, so it should be taken with food and avoided if they are getting heartburn or have previously had stomach ulcers or bleeding problems.
For those under 16 years, aspirin should be avoided. This is because it carries a risk of Reye's syndrome, a rare but serious condition where the liver and brain become swollen.
Do not give your child any adult medications you might have handy, like naproxen, as these are not licensed for children.
For long-term pain, such as in the case of cancer treatment or ongoing inflammatory joint conditions, pain can be persistent or severe and should be discussed with your child's specialist or the multi-disciplinary team looking after them. They may consider prescribing other medications, such as opioids (codeine or morphine), after careful consideration.
When should I take my child to the doctor?
It’s common for children to complain of pain, but this is usually fleeting and mild, and the cause is apparent. Reassurance and distraction may be enough to ease the pain.
In those less than 5 years old, they will often complain of tummy pain, as they have learned that this gets a response. Whether they have tummy pain or not, they have alerted you that they are uncomfortable and in distress, so it’s worth taking notice of this.
If you are finding it hard to work out a simple cause for your child’s pain, if acetaminophen and ibuprofen aren’t easing it, or if you’ve needed to give regular pain relief for more than 24 hours, any of these might be reasons to consult your doctor. You know your child best, so trust your instinct and call your doctor if you think something is wrong.
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