Very young children and pain
If young children knock themselves or fall you can tell whether they have hurt themselves, often because there will be tears and wounds to prove it. If they have a tummy or head ache it is more difficult because the child is too young to communicate where it hurts or how it hurts. But parents know that something is wrong, because the child is not their ‘normal’ self.
When a child has a pain for many days or weeks, it seems likely that she may begin to regard that pain as being ‘normal’. Evidence from older children anecdotally supports this. For example, one thirteen year old girl said that she had believed until recently, that everybody felt pain walking down stairs. She certainly had always felt pain in her hips, knees and feet and expected that this was normal. It was only later that she discovered that this was not ‘normal’ but it was because she had arthritis.
Older children in pain
There is some research evidence that older children learn about pain from the adults around them. They may learn that saying you hurt gets a lot of attention. As childrens’ vocabulary increases, and they become more aware of different parts of their body, children become more skilled at locating their pain and describing it. You can help by explaining describing words that you know they understand, for example whether it is sharp cutting pain, or hot, or dull and achy, or heavy and stiff pain etc. Developing a descriptive scale may also help your child communicate their experience of pain (see below).
Summary of key points
- Parents know when their child hurts
- Most parents are able to describe how their child’s behaviour changes when the child is in pain. Parents describe how she walks differently, or becomes quiet or sweaty, or how she avoids specific actions or become disinterested in playing.
- All these are signs that something is wrong and parents can help healthcare workers track down the source of discomfort or pain if they can clearly describe how the child’s behaviour is different.
- You can understand what a child is feeling if you develop a points system with them. For example if 10 = the worst possible pain, while 1= just a little ache, the child can say what score their hurt has reached. Children learn to differentiate between trivial and significant pain. A points system gives the adult and child a shared scale of hurt.
- Be confident that you know your child, but help the healthcare worker understand your child by giving clear examples about how your child’s behaviour changes.
Checklist for the whole family
- Try to do things as a family – it’s easy to concentrate too much on your ill child and get the balance wrong. See section about family members (see Chapters 12-15).
- In the early days or during a crisis, appoint someone outside the home to be the contact person for giving others news; it can be extra tiring, and depressing to go over the same news time after time yourself.
- Don’t be afraid to take the phone off the hook, so that you can enjoy some well-earned peace and quiet.
- Discuss what happened at appointments or when in hospital with the whole family, and ask how every one feels about these things. Sometimes people don’t express feelings because they try to protect each other, and everyone ends up thinking they’re alone. By discussing things each time, you will find that you can then understand how each member of the family is feeling, and you can support each other.
