As more and more hospitals send children home fairly quickly after surgery – many within hours after an outpatient procedure – it falls on parents to monitor and control their child’s pain. This can be frightening for some parents, confusing to others, or a combination of both. As a result, many parents just flat-out refuse to give pain medication to their kids. What percentage of parents don’t give adequate pain relief through medication to their children?
In a study of 261 children, 24% of parents gave either no medication or a single dose, even though 86% of parents reported that their child was in “significant pain” on the first day after surgery, according to the study of children ages 2 to 12 published in October in Pediatrics. Doctors typically advise parents to give pain relievers every four hours as needed.
What makes the issue of pain involving children even more challenging is that it is not always easy to tell whether a child is in pain or to what extent. What are some of the signals that a child is in pain? Here’s some insight:
Recognizing and treating pain in children can be a challenge. Unlike adults, kids may not cry or complain when in pain, says Lisa Humphrey, Medical Director of the Pediatric Palliative Care Program at Rainbow Babies & Children’s Hospital in Cleveland. Instead, kids may show these symptoms:
• Refusing to eat or drink.
• Becoming quiet, withdrawn.
• Having trouble sleeping.
• Becoming fussy.
• Showing other changes in mood or behavior.
It is also suggested that doctors do more than just write a post-procedure prescription and then hand it to the child’s caregiver. Pediatrician Zeev Kain, Chairman of Anesthesiology at the University of California-Irvine, encourages doctors to take an active role in advising and guiding parents in the aftercare of their little ones:
“[D]octors give parents relatively little information about how to care for these young patients,” Kain says. “It’s not enough to hand parents a prescription,” he says. “Doctors and nurses need to make sure parents will actually give the medication.”
“Without such guidance, parents who are afraid of medication side effects often intentionally withhold medication,” he says.
Once a caregiver is educated and knows what to do and how to do it, then there is the issue of having the child actually take the medicine. What if they are fussy, don’t like the taste, or simply will not listen? Dr. Humphrey provides one answer:
Parents also can request that children try a dose of medication before leaving the hospital, to make sure they are willing to swallow it.
Dr. Mark Brown, an ear, nose and throat specialist in Austin, provides another:
If children don’t like the taste, parents can ask pharmacists to create alcohol-free versions, which are more palatable, says Mark Brown, an ear, nose and throat surgeon in Austin. Many pharmacies are now willing to add a child’s favorite flavor, such as orange or grape.
So, the next time the doctor hands you that prescription for your little one, and your mind starts to race with questions about dependency, side effects, or issues involving how to administer the medication, there is one thing you can do before the doctor turns to leave to see the next patient: ask for help and guidance!