Pain relief for sick babies and toddlers
Caring for sick kids can be very stressful, particularly if they are experiencing pain due to fever, toothache, ear ache or any of the many other common childhood illnesses that can cause discomfort.
Learning when to give pain relief and how to identify the analgesic you should use to address your unwell child’s specific symptoms will not only keep your child calmer, but it will also give you confidence in your ability to properly care for your sick child.
Pain relief and analgesics
The term analgesic describes any medicine that is taken to relieve pain. Also known as painkillers, analgesics do nothing to address the symptoms of pain, instead, they mask it to give temporary relief to the sufferer.
When to give pain relief
Knowing when to give pain relief can be difficult, particularly if you have a young child who is unable to tell you how he is feeling or to describe his symptoms. While every twinge and whinge doesn’t require an analgesic, generally symptoms that indicate your child is not well include:
- Loss of appetite
When your child develops a fever, it is often the first clue parents get that their child is ill. A fever generally develops as the result of your child’s body fighting an infection, and so the appearance of a fever is not necessarily something to worry about as it’s the body’s natural reaction when fighting off infection and may even help the immune system to mature.
However, if your child’s fever or other symptoms of illness are causing him discomfort, administering an analgesic to reduce the symptoms is appropriate. Always read the label of any medicines, follow the instructions and ensure that the correct dosage is administered. Consult a doctor before giving medicines to children under 12 months of age.
Active ingredients in pain relief
All over-the counter pain relief contain active ingredients that make them work in different ways, and so it’s best to administer a product containing an active ingredient that will specifically address your child’s symptoms.
ParacetamolParacetamol is particularly effective at reducing fever as well as post immunisation discomfort. In older children and adults paracetalmol is effective against the pain associated with headaches and tooth extractions. As there are a variety of liquid paracetamol products specifically designed for children in varying doses, it is extremely important that you always read the label to ensure you are giving the correct dose as directed.
IbuprofenIbuprofen is an anti-inflammatory drug and as such, it reduces pain associated with swelling such as sore throats, earaches, strains and sprains as well as fevers, cold and flu symptoms. Side effects of ibuprofen can include nausea and stomach ache and so it is advised that it be taken with food to minimise these side-effects. Do not give ibuprofen if your child may be dehydrated due to vomiting or diarrhoea. Children with asthma should only take ibuprofen after discussion with your GP. It is not recommended that babies (children under 1 year) have Ibuprofen so we also recommend discussing this with your GP.
AntihistamineAntihistamines work to block the symptoms of allergic reactions such as skin conditions including hives and contact dermatitis, hayfever, and allergic reactions to bites and stings. Side effects of antihistamines can include drowsiness, a dry mouth and an upset tummy. The drowsiness that antihistamines can induce has historically made it popular in putting children to sleep, however in some children antihistamines can have a stimulating effect. It is never advisable to administer a drug for any other reason than to address specific symptoms.
CodeineCodeine is an opiod analgesic and is much stronger than paracetamol so should only be used to bring relief of moderate to strong pain. It’s generally not recommended for babies under 12 months. Codeine is excellent at controlling pain associated with acute earache, dental procedures, post-operative pain, soft tissue injuries and fractures. Side effects can include drowsiness and constipation. As it is an opiod, short-term use of codeine is advisable and under your doctor’s instructions.
AspirinAspirin is not recommended for children under 16 years as this medication in children has been linked to the rare but often fatal Reye’s syndrome. Aspirin is also called ‘salicylate’ or ‘acetylsaliclic acid’ and can sometimes be found in other over-the-counter preparations, so always check with your pharmacist first before giving your kids a new analgesic.
Call the Poisons Information Centre immediately on 0800 764 766 if your child has taken more then the recommended dose of any analgesic.
Treating a fever
All children, particularly young children, have less control over their body temperature (which is why they can lose so much heat through the top of their head and require a hat during winter) and so when they become ill and develop a fever, their temperature can increase very quickly and reach dangerous heights where febrile seizures are possible. For this reason, along with the general discomfort that accompanies a fever, it is advisable to take steps to reduce your child’s fever as soon as you detect it:
- Give an appropriate analgesic in the correct dose to bring the temperature down
- Give plenty of fluids, particularly water
- Sponge the exposed skin with tepid water (cold water is usually too painful on feverish skin). Using a fan over the sponged skin will increase the cooling effect
- Don’t allow your child to become cold as this will cause shivering and shivering creates more heat in the body
- Keep your child in bed as he will need to have plenty of rest to recuperate properly
If you are having difficulty keeping your child’s temperature down between doses of analgesic, you can give alternate doses of paracetamol and ibuprofen – you must still follow the dosage guide for each drug but you can give paracetamol and then follow two hours later, with a dose of ibuprofen. Discuss this procedure with your pharmacist before beginning this routine as it is not recommended that children under one year take ibuprofen.
When should I take my child to the doctor?
While almost all fevers and pain in childhood are due to non-threatening illnesses that pass in a day or two, you should take your sick child to the doctor if:
- You are worried
- He is under 12 months old and has a fever
- He has a fever that continues for more than 48 hours
- He has a very high temperature - over 40º C
- He convulses
- He is getting sicker
- He is very sleepy or particularly irritable
- He has a rash
- He shows unusual symptoms including a stiff neck, vomiting, stomach pains, or skin discolouration
- He is experiencing ongoing pain, for example, stomach ache, headache or earache
- He has an injury and is experiencing pain
- He is having trouble breathing due to a cough or wheezing
- He is vomiting or isn’t able to drink
Healthline has a free telephone health advice service called Well Child. The Well Child service provides information, advice and support for parents and caregivers of children up to five years. Parents commonly call Well Child to discuss their child's health.
Whenever you have concerns about your child you can ring the Well Child service and talk to a nurse about what to do. Nurses might advise you to contact your GP or Well Child provider the next day, or offer advice over the phone on issues like feeding or sleeping.
Call Well Child FREE on 0800 611 116 anytime from either a landline or a cell phone.
- This article was written by Ella Walsh for Kidspot – New Zealand’s leading website for kids’ health. Sources include Royal Hospital for Children, Melbourne, Better Health Channel and Children and Youth Health.
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