How Pain Affects Your Child and How You Can Help
By Judith Tighe, RN, CPN, lead RN, Medical/Surgical Unit (5 west) at Children's Hospital Los Angeles.
It was a good thing I asked my husband to accompany me and our daughter to the dentist for the dreaded wisdom teeth extraction. As we walked to the car my daughter who is eight inches taller than me, buckled towards the asphalt and was caught by my husband. When we got home, my daughter went to bed, to sleep off the anesthetic. For the next two days, I responded to her requests, feeling guilty to have put her through so much suffering as she was clearly in pain. She refused to take pain medication because it made her feel nauseated and she cried every time she saw the bloody gauze from her mouth. She was 16 when this happened and some of her behavior was similar to a small child. This is what inspired my blog post about behavior changes in children after surgery.
Here are tips for reading behavior changes and managing their pain.
Behavior Changes After a Medical Procedure
The recovery time, at home, following your child’s medical procedure can bring out different behaviors because of the emotional impact of having a procedure and the pain afterwards. These behavior changes can last up to two weeks. Behavior changes you may see in younger children include:
- Anxiety because a young child may not understand what has happened.
- The inability to express feelings.
- Thinking the procedure was a punishment.
- Misbehavior and acting out.
- Bathroom accidents, even if they’re toilet trained.
- Abnormal sleep patterns and nightmares.
- A poor appetite.
Some behavior changes you may see in older children include:
- Becoming overly attached to one or both parents.
- Testing limits /rules
- Lack of independence.
- Withdrawing into themselves.
Note to parents: For any medical procedure in a doctors’ office, clinic, surgical center or hospital, you should be allowed to stay with your child until they fall asleep from the anesthesia.
Tips on Helping Your Child at Home
Pain is a difficult thing to measure and we all perceive it differently. For example, what is small pain to one child may be more pain to another. Older children may not want to admit being in pain and younger children may not be able to express they hurt except by crying or moaning. It is important to be sensitive to your child’s expression of pain and provide relief. Here are some tips:
- Provide your child with adequate pain medication that is needed for their recovery.
- After giving your child prescribed medication, give them a small massage or cuddle as a way to distract from pain and soothe.
- Introduce soft and bland foods as your child’s appetite returns, which is usually after 12-24 hours.
- Rest is important for a faster recovery, especially because your child may be tired, sore or in pain.
- Encourage quiet, gentle activity and gradually ease back into a normal routine.
- Try “playing doctor and nurse.” Acting out the experience can lessen anxiety and stress.
- Limit physical activity and rough play with siblings and friends.
- Have supplies ready for quiet activities, like coloring books, puzzles, etc.
- Try to limit intense TV shows or computer games.
Having your child’s favorite foods in the house helps reduce anxiety and help with pain management. Before your child’s medical procedure, stock up on their favorites foods and include:
- Fruit juice
- Flavor enhancers that you can add to water
Can Kids Become Addicted to Pain Medicine?
Managing a child’s pain properly will lessen the behavior changes. Your child’s recovery will be faster and more comfortable for everyone. Parents are often hesitant to give their children medication for pain. Sometimes it is because they are afraid their child will become addicted. This is not the case. Susan Hunt, RN, MSN, CPNP, nurse consultant, Anesthesiology Critical Care Medicine Department at Children’s Hospital Los Angeles shares,
“It is very rare for children to become addicted to pain medications such as opioids when these medications are used appropriately and for the right reasons such as management of pain after surgery. If pain is not adequately controlled after surgery, this can lead to complications such as increase hospital stay, slower wound healing, pneumonia, lack of sleep, fear and anxiety and increased risk of developing chronic pain.”
Patience and a supportive approach with your child will help have your family-life back to normal. Within five days after my daughter’s procedure, she was back to her normal self. She was proud of the fact that she had overcome the wisdom teeth “rite of passage.” I encourage you to share these tips with parents currently experiencing or will experience their child undergoing a medical procedure.