Sunday, July 20, 2008

How to keep our children pain-free

By: Jenny Walters

A recent article on Cnn.com entitled How to keep your kids pain-free by Elizabeth Cohen, dealt with 5 ways that a parent can use to help alleviate a child’s pain.

Dr. Jodi Greenwald, a pediatrician in Roswell, Georgia, uses a “secret weapon” for pediatric pain relief, a pinwheel. Dr. Greenwald stated: “Tell them to blow the pinwheel to make it turn, and you’re accomplishing two things…It distracts the child while they’re getting a shot and it makes them take deep breaths, which helps them relax.”[1]

Following giving birth to her son, Jennifer Crain discovered an anti-pain weapon too; a pacifier dipped in sucrose water. Nurses used this during her son’s circumcision. Researchers believe that sucking on sugar water changes the neurochemicals in the brain of the neonate.

Pediatric pain experts report that “sadly, too many children aren’t getting any pain relief, even something as simple as a pinwheel or sugar water.” A recent study in the Journal of American Medical Association, found that “four out of five babies in the neonatal intensive are unit received no pain relief when they had to undergo painful procedures.”

A study in France also found that U.S. doctors do not give pain relief to babies and children as often as they should. According to Dr. Brenda McClain, director of pediatric pain management at Yale-New Haven Children’s Hospital in Connecticut: “We may not see children’s pain as that severe. But pediatric pain needs to be taken seriously. However, most of the time I don’t think we see it that way.”

Below are five techniques that a parent can use to help alleviate a child’s pain:

1. For babies, ask about a pacifier dipped in sucrose water: Doctors say this works wonders in babies. If your pediatrician does not have sucrose water, you can make your own by dipping a pacifier into a mixture of one teaspoon table sugar and four teaspoons water. You can give your baby the pacifier about 30 minutes before a shot or procedure.

2. Ask for a topical pain cream: Creams can help take the sting out of a needle stuck. However, many doctors don’t use the topical creams, because they complain they take too long to work and they have to “sit there and wait until the cream takes effect.” You can ask your doctor for a prescription and apply the cream before you arrive at the doctor’s office. The cream needs to be applied 30 minutes to two hours before the procedure or shot.

3. Distract your child: Talking to your child about anything, but what is going on. Parents make the mistake of saying things like “We’ll get ice cream when it’s over” or “I know it hurts.” Instead it is better to talk to your child about good memories. For example, “Remember the time we went to Disney and you got to meet Mickey Mouse.”

4. Ask about alternative treatments: Acupuncture, music therapy, and hypnosis have all been used to treat children’s pain.

5. Don’t be afraid of opiates: According to pediatric pain experts, opiates can help a child in sever pain, and the risks are small. “It is very rare for children to get more pain medicine than they need or to get addicted to pain medicine” according to pain management program at the Seattle Cancer Care Alliance.

Overall, if your child is not getting enough pain relief, you, as the parent, may have to step in.

This article was not only important to me as a parent, but also as a neonatal intensive care nurse. In the neonatal intensive care unit (NICU), we used a specific pain scales designed specifically for the neonates, and we used sugar water and various pain medications to help alleviate the neonate’s pain.

I have to disagree somewhat with the research findings of “four out of five babies in the neonatal intensive are unit received no pain relief when they had to undergo painful procedures.” Pain was one the biggest concerns in the NICU. We were adamant about preventing and managing the neonate’s pain. Although there are and will always be a hand full of nurses and doctors who do not make pain management their priority, the majority of nurses and doctors are very much so concerned with pain management for neonates and children alike.

[1] Cohen E. How to keep your kids pain-free. July 2008. Available at: http://us.cnn.com/2008/HEALTH/07/10/ep.child.pain/index.html. Accessed on July 18, 2008.

1 comment:

Anonymous said...

So why was I tortured in one of those old crippled children's hospitals in 1971, given totally inadequate pain relief after major spinal reconstructive surgery, was told by the nurses and aids to "shut up" when I yelled because I distracted the "doctor"? Why did they tell me I'd become addicted to morphine if they gave me over 7 shots (small doses, I have my old records) total? Why was I in constant, horrible pain that kept me from breathing, for days and days, tied down to bed for weeks on end in skeletal traction, with casts, my infected back debrided in the room without benefit of anesthesia? Why do I still have PTSD over this? Where were the advocates who could have helped me then?