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Pain, Ways to Help Your Child Cope with

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Ways to Help Your Child Cope with Pain

We can work together to help your child cope with pain by using medicine and coping techniques. When dealing with painful events, children need time to ask questions and share their feelings. Give simple truthful facts to build your child’s trust. This may reduce his stress level. Use a quiet, even-toned voice and stay positive. Give your child lots of praise and the chance to make choices when possible. During a procedure, give your child a job or small task – even if it’s just holding something or watching something.

Children of different ages understand and respond to pain differently.

Infants (0-12 Months)

Your infant may show certain signs that he/she is in pain. Signs of pain for infants are restlessness, withdrawal/poor response to parents, less appetite, clinging, whining, or facial cues that indicate discomfort.

Toddlers (1-3 Years)

Toddlers may strike out physically or verbally when they hurt. They are unable to understand what is happening. They may think the pain is punishment. They need to know they are not being punished for doing anything wrong. A security object, such as a favorite toy or blanket, may be helpful. A toddler who is in pain may whimper, cry, scream, cling to a parent, thrash about, withdraw, get stiff, refuse to eat, refuse to use the toilet, have anxious facial expressions or hide his face A toddler may be able to point to the pain, or just describe it as “hurt” or “owie.” Please tell us if your toddler has a special word for pain.

Preschoolers (3-5 Years)

Preschoolers are magical thinkers and, like the toddler, may not understand why they are in pain. They often fear or imagine they have done something wrong to “deserve” the pain. They may also fear separation from parents or brothers/sisters. Preschoolers may find comfort and a sense of control when family and familiar people visit. Playing with favorite toys or going to the playroom may help preschoolers cope with pain. Toddlers and preschoolers have vivid imaginations, so stories or games can be very helpful with pain and anxiety. They often show their pain by crying, shrieking without tears, withdrawal, regression to behaviors they used to do when they were younger, anxiety and lack of interest in play. They might ask a lot of “why” questions or “what are you doing?” Simple, truthful answers are best.

School-age (6-12 Years)

School-age children begin to be able to think logically. They can figure out why things are happening to them. They are usually able to describe, locate and talk about the level of their pain. School-age children may fear that the procedures or equipment we use in the hospital will mutilate their bodies (needles, incisions, etc.) The stress of being hospitalized and being in pain may cause them fear of losing self-control. You may need to help your child practice relaxation techniques often. Children may ask for pain medicines but may also deny that they have pain. School-age children often show their pain with unstable moods, outbursts, lashing out, refusing to care for themselves, withdrawal, quietness, regression and anxious facial expressions.

Adolescent (13 and up)

Teens are able to reason out the events around them. They are very concerned with being accepted by their peers. Teens are often afraid of losing self-control and looking like a baby. They may be comforted by having friends or family around, but may prefer to be alone. They may show their pain with aggression, withdrawal, refusing self-care/hygiene, poor eating, or depression. Most teens want to make choices about controlling their pain. Offer teens reasonable choices so they have some control in the hospital setting. This age group may be hesitant to learn relaxation techniques and need more support and practice with these techniques.

Choosing non-medicine techniques to help your child cope

You can choose pain control techniques for your child based on his/her developmental age. These techniques are often good at decreasing mild to moderate pain. For severe pain, these techniques can help when they are used in addition to pain medicines. Many times pain and anxiety go together. Sometimes fear and anxiety can look like pain in very young children. Anxiety or fear can increase the amount of pain. Coping techniques can help relax and/or distract your child as well as decrease pain. The more you and your child practice the techniques, the better they work.

Using the coping techniques

Remember, you can be your child’s coach and help him/her relax during painful experiences. Practice is very important, even before a painful experience occurs so your child has the tools to cope during it. Practice helps your child get familiar with the techniques, and builds confidence. Some techniques you can use are listed and explained below.

Age GroupTechnique for Coping
Infant (Under 1 year)Rhythmic Voice
Gentle Massage
Soft Music
Slow Breathing
Using a Favorite Object
Toddler/Preschooler (1-5 year olds)Distraction
Thought Stopping
Deep Breathing
School Age (6-12 years) & Adolescent (13 & up)Progressive Relaxation
Thought Stopping
Deep Breathing


Deep Breathing: Have your child breathe in deeply through his/her nose and blow out through his/her mouth. Encourage this throughout the painful experience. Do the breathing with your child to show him/her. Pretend you are blowing out candles on a birthday cake. Blowing bubbles works well with younger children. This technique can reduce pain and give the child a feeling of self-control.

Thought Stopping: This technique is used prior to and after a painful experience. Encourage your child to substitute negative thoughts with positive thoughts. (“I know I can do it” or “This might hurt, but I will feel better soon”). The Little Engine That Could can be read to younger children.

Rehearsal: Prior to the procedure/painful event, act out or rehearse what will happen. Let your child come up with his/her own coping skills. Help him/her to imagine doing well. Dolls and toys are often used with younger children to allow them to “play out” their fears.

Distraction: Help your child focus on something other than the pain. Read a book, watch a movie, listen to music, recite familiar nursery rhymes or poems, practice counting or doing the alphabet, play electronic games or blow bubbles. Your nurse or a child life specialist can offer other ideas or toys for distraction, such as glitter wands, sand toys or Magna Doodles®.

Imagination: Help your child see a picture in his/her mind of something he/she likes. Combine this with deep breathing. Ask your child about what he/she sees at this favorite place in his/her mind – help him/her describe it in detail. Some ideas include a favorite activity, vacation spot, nature scenes or school. This is often relaxing as well as distracting for the child and can lessen their anxiety or fear.

Progressive Relaxation: This skill takes a lot of practice. Your child first tightens a muscle group for about seven seconds, then relaxes it for about 4 to 5 seconds (muscle groups include the muscles of the face, shoulders, neck, arms, legs, back, hands and feet). You can help coach your child to breathe deeply and relax during this technique. If you have any questions about this technique, let your nurse know.

Child life specialists at CHKD

Our child life specialists and nurses are trained to help children cope with pain. Child life specialists can teach you and your child coping techniques. You can help your child have control over his/her pain by coaching him/her and practicing these coping techniques with him/her.

Disclaimer: This information is not intended to substitute or replace the professional medical advice you receive from your child's physician. The content provided on this page is for informational purposes only, and was not designed to diagnose or treat a health problem or disease. Please consult your child's physician with any questions or concerns you may have regarding a medical condition.

Reviewed: 1/2018

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