tag:theconversation.com,2011:/us/topics/pain-in-kids-37654/articlespain in kids – The Conversation2020-12-21T16:50:52Ztag:theconversation.com,2011:article/1491312020-12-21T16:50:52Z2020-12-21T16:50:52ZDisney, Pixar and Netflix are teaching your children the wrong messages about pain<figure><img src="https://images.theconversation.com/files/375616/original/file-20201217-23-mmb9ym.jpg?ixlib=rb-1.1.0&rect=76%2C0%2C4157%2C2830&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">At critical developmental periods when young children are learning about themselves, others and the world, they are frequently seeing pain portrayed unrealistically in kids' TV shows and movies.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>Mass media exert an <a href="https://dx.doi.org/10.1093%2Fpch%2F8.5.301">enormous influence on children’s development</a> and is very likely how they learn about pain. Understanding the powerful influence that media has on preschoolers and kindergarteners is important because this is a crucial developmental period for socio-emotional development and is precisely the time when <a href="https://doi.org/10.1111/j.1365-2214.2010.01171.x">fears about pain (especially needles) develop</a>.</p>
<p>Like it or not, pain is an inevitable part of childhood. In Canada, children receive <a href="https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-1-key-immunization-information/page-13-recommended-immunization-schedules.html#p1c12a2">20 vaccine injections before the age of five</a>. From the time that toddlers begin walking, everyday pains or “boo-boos” — minor injuries that result in bumps and bruises — are extremely common, <a href="https://doi.org/10.1155/1998/198043">occurring nearly every two hours</a>. </p>
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<img alt="A child on a sofa pointing a remote control." src="https://images.theconversation.com/files/375310/original/file-20201216-13-1rktxwv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/375310/original/file-20201216-13-1rktxwv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=900&fit=crop&dpr=1 600w, https://images.theconversation.com/files/375310/original/file-20201216-13-1rktxwv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=900&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/375310/original/file-20201216-13-1rktxwv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=900&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/375310/original/file-20201216-13-1rktxwv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1131&fit=crop&dpr=1 754w, https://images.theconversation.com/files/375310/original/file-20201216-13-1rktxwv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1131&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/375310/original/file-20201216-13-1rktxwv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1131&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Media can be powerful influence on preschoolers and kindergarteners at a crucial period of development when fears about pain (especially needles) develop.</span>
<span class="attribution"><span class="source">(Pexels/Ketut Subiyanto)</span></span>
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<p>By the time they reach adolescence, <a href="https://doi.org/10.1016/j.pain.2007.10.032">one in five youth will develop chronic pain</a>. This means pain lasting for three months or more, like headaches and stomach aches. Chronic pain is a rising epidemic around the world, <a href="https://doi.org/10.1016/j.pain.2011.07.016">especially in girls</a>. If these youth do not receive proper treatment, chronic pain during adolescence can lead to pain and <a href="https://doi.org/10.1097/j.pain.0000000000000522">mental health issues</a> (PTSD, anxiety, depression, <a href="https://doi.org/10.1016/j.jpain.2018.07.007">opioid misuse</a>) into adulthood.</p>
<p>Simply put, pain is a big part of childhood. Yet, as a society we avoid, undertreat and stigmatize pain. Despite decades of research showing how to effectively manage children’s pain (for example, using numbing creams or distraction techniques), studies show that many clinicians still <a href="https://doi.org/10.1155/2014/614784">undertreat children’s pain</a>, and neither acute (short-lasting) nor chronic (<a href="https://doi.org/10.1155/2011/654651">lasting three months or more</a>) pain is well-managed. </p>
<p>Children who experience chronic pain <a href="https://doi.org/10.1097/j.pain.0000000000000512">are also stigmatized</a> and often <a href="https://doi.org/10.1097/PR9.0000000000000679">disbelieved by peers, health-care professionals and teachers</a>. These deeply ingrained societal beliefs about pain likely influence how children learn to experience, respond and empathize with pain. </p>
<p>So where does this social stigma of pain come from? What do Disney, Pixar and Netflix have to do with your child’s pain? </p>
<h2>Children’s media exposure</h2>
<p>Children are growing up saturated with mass media and <a href="https://doi.org/10.1001/jama.2019.21854">rates of screen time are rising</a>. The COVID-19 pandemic has only fuelled this further. While the American Academy of Pediatrics recommends that preschool-aged children watch <a href="https://www.healthychildren.org/English/news/Pages/AAP-Announces-New-Recommendations-for-Childrens-Media-Use.aspx">no more than one hour of TV per day</a>, the majority of children <a href="https://doi.org/10.1001/jamapediatrics.2018.5546">far exceed this recommendation</a>. </p>
<p><a href="https://doi.org/10.1097/j.pain.0000000000002086">In our study</a>, we used popular culture lists to capture the most popular movies and TV shows seen by millions of four-to-six-year-old children. The final list included <em>Despicable Me 2</em>, <em>The Secret Life of Pets</em>, <em>Toy Story 3</em> and <em>4</em>, <em>Incredibles 2</em>, <em>Inside Out</em>, <em>Up</em>, <em>Zootopia</em>, <em>Frozen</em>, <em>Finding Dory</em>, <em>Sofia the First</em>, <em>Shimmer and Shine</em>, <em>Paw Patrol</em>, <em>Octonauts</em>, <em>Peppa Pig</em> and <em>Daniel Tiger’s Neighbourhood</em>. </p>
<p>We watched all 52.38 hours of media and all instances of pain were captured. We used established coding schemes drawn from the procedural and everyday pain literature to code details of the pain experience, including both the sufferers’ and the observers’ responses, the type of pains depicted and the degree to which observers showed empathy to the characters in pain. We examined gender differences in the pain experiences of boy versus girl characters. </p>
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<a href="https://images.theconversation.com/files/375300/original/file-20201216-17-1bdhdxp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Two children sitting on the floor watching a cartoon." src="https://images.theconversation.com/files/375300/original/file-20201216-17-1bdhdxp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/375300/original/file-20201216-17-1bdhdxp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=902&fit=crop&dpr=1 600w, https://images.theconversation.com/files/375300/original/file-20201216-17-1bdhdxp.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=902&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/375300/original/file-20201216-17-1bdhdxp.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=902&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/375300/original/file-20201216-17-1bdhdxp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1134&fit=crop&dpr=1 754w, https://images.theconversation.com/files/375300/original/file-20201216-17-1bdhdxp.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1134&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/375300/original/file-20201216-17-1bdhdxp.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1134&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Research showed that pain was depicted approximately nine times per hour in children’s media.</span>
<span class="attribution"><span class="source">(Pexels/Victoria Borodinova)</span></span>
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<p>The results were shocking. Pain was frequently depicted, approximately nine times per hour. Seventy-nine per cent of pain instances involved characters being seriously injured or experiencing pain due to violent acts. Although everyday pains are the most common pain experiences young children experience in real life, everyday pains comprised only 20 per cent of the pain instances. Medical and procedural pain, like needles, as well as chronic pains were depicted less than one per cent of the time. </p>
<p>When characters experienced pain, they rarely (only 10 per cent of the time) asked for help or showed a reaction, perpetuating an unrealistic and distorted perception of pain that shows pain as being quickly swept aside. Although 75 per cent of pain instances were witnessed by observers, they rarely responded to characters experiencing pain, and when they did, they showed very low levels of empathy or concern toward the sufferer. </p>
<p>Across the media, boy characters experienced the vast majority of pain, despite girls experiencing higher rates of pain problems in real life. This underrepresentation of pain in girl characters could be teaching young children that girls’ pain is less frequent, real and worthy of attention from others. Indeed, we found that girl characters were less likely to seek help when they experienced pain than boy characters. </p>
<p>Boy characters experienced more severe and distressing pain than girls; however, observers were more concerned about, and likely to help, girl characters. Observers were more likely to show inappropriate responses (laughter) to boy sufferers. Boy observers were more likely to laugh and offer verbal advice to sufferers, whereas girl observers were more empathetic toward sufferers. </p>
<h2>Frequent and unrealistic portrayals of pain</h2>
<p>These findings reveal that popular media are perpetuating unhelpful gender stereotypes about pain, with girls being depicted as damsels in distress who show more caring and empathy and require more help, and boys being portrayed as stoic and uncaring towards others.</p>
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<img alt="A child using a tablet." src="https://images.theconversation.com/files/375298/original/file-20201216-19-14072ge.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/375298/original/file-20201216-19-14072ge.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/375298/original/file-20201216-19-14072ge.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/375298/original/file-20201216-19-14072ge.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/375298/original/file-20201216-19-14072ge.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/375298/original/file-20201216-19-14072ge.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/375298/original/file-20201216-19-14072ge.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Children are growing up saturated with mass media and rates of screen time are rising.</span>
<span class="attribution"><span class="source">(Pexels/Karolina Grabowska)</span></span>
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</figure>
<p>At critical developmental periods when young children are learning about themselves, others and the world, they are seeing pain frequently portrayed in their favourite TV shows and movies. In children’s media, pain is frequently depicted (nine times per hour), it is unrealistically and often violently portrayed, empathy and helping is rarely depicted, and unhelpful gender stereotypes abound.</p>
<p>These messages are potentially harmful as we know that children turn to their favourite characters to understand and make sense of their everyday experiences such as pain and importantly, to learn how to respond to their own pain and pain in others.</p>
<p>These findings highlight a pervasive societal stigma around pain that is being communicated to young children. This highlights the responsibility that we all have in dismantling and changing these societal narratives about pain to ensure that this powerful social learning opportunity is not missed and we are raising more prepared and empathic children for the inevitable pains they will encounter throughout their lives.</p>
<hr>
<p><em>This story is part of a series produced by SKIP (Solutions for Kids in Pain), a national knowledge mobilization network whose mission is to improve children’s pain management by mobilizing evidence-based solutions through co-ordination and collaboration.</em></p><img src="https://counter.theconversation.com/content/149131/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Melanie Noel receives funding from CIHR, SSHRC, Alberta Children's Hospital Research Institute, Chronic Pain Network.</span></em></p><p class="fine-print"><em><span>Abbie Jordan receives funding from the Pain Relief Foundation, Sir Halley Stewart Trust and Royal United Hospitals Foundation Trust.</span></em></p>In children’s media, pain is depicted alarmingly frequently, usually unrealistically and often violently, but without empathy or help. These images of pain send all the wrong messages.Melanie Noel, Associate Professor of Clinical Psychology, University of CalgaryAbbie Jordan, Senior Lecturer in Psychology, University of BathLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1483052020-11-11T16:04:35Z2020-11-11T16:04:35ZThe power of parents: 3 ways you can reduce your baby’s pain during medical procedures<figure><img src="https://images.theconversation.com/files/367544/original/file-20201104-15-khd3h7.jpg?ixlib=rb-1.1.0&rect=0%2C2057%2C3817%2C3035&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Parents can provide effective comfort and pain management for their infants.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>All babies undergo painful procedures, including injections of medications, <a href="https://www.aboutkidshealth.ca/article?contentid=1986&language=english">injections of vaccines</a> and <a href="http://www.iwk.nshealth.ca/women-and-newborns-health/services#/women-and-newborns-health/newborn-screening">heel sticks to collect blood for routine tests</a>. These procedures occur shortly after birth, during the first few days after birth and throughout a baby’s first year. </p>
<p>Thanks to over two decades of research, we know that there are highly effective strategies to help reduce babies’ pain when they have to undergo painful procedures: Breastfeeding and parent-infant skin-to-skin contact. </p>
<p>These strategies are safe, accessible, supported by science and recommended by organizations such as the <a href="https://doi.org/10.1542/peds.2006-2277">Canadian Paediatric Society</a> for minimizing pain in infants up to 12 months old. They are also parent-led — meaning that parents are the source of comfort for their newborns. </p>
<p>However, despite the pain-reducing benefit of using these strategies, they are not always used to manage infant pain. In fact, studies show that <a href="https://doi.org/10.1097/AJP.0b013e3181fe14cf">less than 50 per cent of newborns receive any form of pain relief</a> during routine medical procedures. In addition to causing unnecessary suffering, unmanaged pain in early life is associated with negative consequences, such as feeling <a href="https://doi.org/10.1016/j.pain.2009.02.012">increased pain during later procedures</a>.</p>
<p>As nurse scientists and experts in infant pain management, we want to highlight key tips and tricks to help you use these parent-led strategies (as well as a few additional ways to reduce your baby’s pain) during their next painful procedure. </p>
<h2>1. Breastfeeding</h2>
<p><a href="https://doi.org/10.1097/JPN.0000000000000253">Direct breastfeeding should be considered the preferred treatment</a> for full-term infants undergoing procedures, such as injections and blood draws, in the first year of life. Breastfeeding babies have lower pain responses, including less crying, less change in their heart rate and lower scores on tools developed to measure infant pain. Consider the following when using breastfeeding as a pain-management strategy for your infant: </p>
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<img alt="A mother breastfeeding her infant." src="https://images.theconversation.com/files/367497/original/file-20201104-15-1q9k48u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/367497/original/file-20201104-15-1q9k48u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=890&fit=crop&dpr=1 600w, https://images.theconversation.com/files/367497/original/file-20201104-15-1q9k48u.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=890&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/367497/original/file-20201104-15-1q9k48u.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=890&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/367497/original/file-20201104-15-1q9k48u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1118&fit=crop&dpr=1 754w, https://images.theconversation.com/files/367497/original/file-20201104-15-1q9k48u.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1118&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/367497/original/file-20201104-15-1q9k48u.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1118&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Ideally, breastfeed your baby for at least two minutes before a painful procedure.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
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<p>• Work with your health-care provider to find a place where you can comfortably breastfeed your baby while they complete the procedure. As a breastfeeding parent, you are the expert in feeding your baby! There is no recommended breastfeeding positioning that is best for pain management — simply what works best for you and your baby to achieve an optimal latch so your baby is able to suck effectively. It is also important that the health-care provider is able to conduct the procedure. </p>
<p>• Ideally, you want to breastfeed your baby for a minimum of two minutes prior to the painful procedure. They should be latched to the breast and actively sucking and swallowing before the painful procedure. Don’t worry, breastfeeding during procedures is safe! There are no reports of baby’s choking while breastfeeding during procedures. </p>
<p>• Continue breastfeeding your baby throughout the painful procedure and for as long as your baby wants to breastfeed afterwards. </p>
<h2>2. Skin-to-skin contact</h2>
<p>Skin-to-skin contact, also sometimes called kangaroo care, involves holding a baby wearing only a diaper against your bare chest. Studies show that babies who are in <a href="https://doi.org/10.1002/14651858.CD008435.pub3">skin-to-skin contact during painful procedures experience less pain</a> during the painful procedure and they recover faster — meaning that if they do experience some pain or distress, it is for less time than if they were not in skin-to-skin contact. While breastfeeding is the best treatment for full-term babies, skin-to-skin contact is recommended for babies who are born prematurely or infants unable to breastfeed. </p>
<p>Using skin-to-skin contact for pain relief is simple and easy. Follow these steps:</p>
<p>• Work with your health-care provider to find a comfortable place to sit, where you can cuddle your baby for 10-15 minutes.</p>
<p>• Undress your baby so they are wearing only a diaper and hold them facing inward with their chest against your bare chest. You can use a blanket over you both for comfort, warmth and privacy. </p>
<p>• Hold your baby in skin-to-skin contact for at least 10 minutes before the painful procedure — up to 15 minutes is ideal. Your baby should be calm and relaxed before the procedure is done. </p>
<p>• Keep your baby in skin-to-skin contact during the procedure and afterwards to help them stay calm and relaxed. </p>
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<img alt="A mother with her infant on her chest, covered by a sheet." src="https://images.theconversation.com/files/368405/original/file-20201109-17-q28915.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/368405/original/file-20201109-17-q28915.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/368405/original/file-20201109-17-q28915.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/368405/original/file-20201109-17-q28915.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/368405/original/file-20201109-17-q28915.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/368405/original/file-20201109-17-q28915.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/368405/original/file-20201109-17-q28915.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Skin-to-skin contact is recommended for babies who are born prematurely or infants unable to breastfeed.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
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<p>Research shows that infants who are in <a href="http://doi.org/10.1001/archpediatrics.2011.130">skin-to-skin contact with mothers during painful procedures have lower pain responses</a>. Fathers, adoptive parents, co-parents and other family members such as grandparents can also provide skin-to-skin contact to help reduce pain during procedures.</p>
<h2>3. Additional ways to reduce your baby’s pain</h2>
<p>If you are not breastfeeding your baby or cuddling your baby in skin-to-skin contact, having them suck on a pacifier or your clean finger during the procedure can reduce their pain as well. You can also use a sweet tasting solution, such as a <a href="https://www.aboutkidshealth.ca/article?contentid=3628&language=english">small amount of sugar water on your baby’s tongue</a>, prior to the procedure or add a <a href="https://www.aboutkidshealth.ca/Article?contentid=3627&language=English">numbing cream</a> about an hour before the procedure to help numb the skin where a needle is to be injected. </p>
<p>Always remember to keep your baby <a href="https://theconversation.com/fear-of-needles-5-simple-ways-to-ease-vaccination-pain-for-your-child-and-yourself-134328">upright and close to you</a>. Babies become more distressed if they are lying flat during injections or procedures. </p>
<p>Many parents do not realize what an important role they can play in reducing their baby’s pain during routine needles and pricks. <a href="https://www.youtube.com/watch?v=3nqN9c3FWn8">Parents are the most important person to their baby</a> and science shows they can provide the ideal pain management and comfort during procedures. Parents also know their baby best, so are in the best position to advocate for the use of strategies that work for managing their baby’s pain. </p>
<p>Talking with your health-care provider about using these pain management strategies for your baby’s next painful procedure will help ensure that they are used. <a href="https://www.kidsinpain.ca/">Solutions for Kids in Pain</a> is also a great resource for up-to-date and evidence-based information on pain in children to help give you the knowledge you need to manage your baby’s pain well. </p>
<p><em>This story is part of a series produced by <a href="https://www.kidsinpain.ca">SKIP (Solutions for Kids in Pain)</a>, a national knowledge mobilization network whose mission is to improve children’s pain management by mobilizing evidence-based solutions through co-ordination and collaboration.</em></p><img src="https://counter.theconversation.com/content/148305/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Britney Benoit receives funding from the QEII Foundation and Nova Scotia Health. </span></em></p><p class="fine-print"><em><span>Marsha Campbell-Yeo receives funding from CIHR, IWK Health, Dalhousie University, ACOA, CCHCSP, NSHRF, and Nova Scotia COVID-19 Health Research Coalition. </span></em></p>There are effective ways to help reduce babies’ pain during blood draws and injections, but they are used in less than 50 per cent of newborns. Here’s how to ease your infant’s pain.Britney Benoit, Assistant Professor of Nursing and Health Sciences Research Chair, St. Francis Xavier UniversityMarsha Campbell-Yeo, Professor, School of Nursing, Dalhousie UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/753972017-04-10T20:08:48Z2017-04-10T20:08:48ZParents’ reactions can lessen or worsen pain for injured kids<figure><img src="https://images.theconversation.com/files/164219/original/image-20170406-16603-1vaaofa.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Medical procedures on your kids are stressful for you - but your stress can make their pain worse. </span> <span class="attribution"><span class="source">from www.shutterstock.com.au</span></span></figcaption></figure><p>Most kids are going to be injured at some point during their childhood. It will be stressful for the child, and potentially even more so for the parent. Parents can <a href="https://www.ncbi.nlm.nih.gov/pubmed/24494782">suffer feelings of guilt and anxiety</a>, and a minority will also develop <a href="https://www.ncbi.nlm.nih.gov/pubmed/24494782">post-traumatic stress</a> following their child’s injury. </p>
<p>Some new research (yet to be published) has looked at family coping and distress during a dressing change following a burn injury in kids. The 18-month study observed 92 families during their young child’s (one to six years) first burn dressing change at a Brisbane hospital.</p>
<p>Parents who reported they were more anxious or distressed were less able to support their child during the procedure. This decreased the child’s ability to cope and increased the child’s distress, which was measured by their ability to be distracted by toys and conversation, compared to crying or screaming during the dressing change.</p>
<p>Ratings of child anxiety and pain during the dressing change were also greater for children of parents who were less able to support their child during the dressing change.</p>
<p><a href="http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.398.5285&rep=rep1&type=pdf">Our minds have a limit</a> to what they can focus on at once. Therefore, a mind that is preoccupied with other things will perceive the pain as less than a mind that is focused on the pain alone. This is why we think distraction is helpful for the child during the dressing change.</p>
<p>The study’s findings show parents need to receive additional support following their child’s injury and during medical treatment. This additional support would benefit the parents, and also the child. A less distressing treatment means less trauma for all, as well as lower pain and anxiety experienced by the child.</p>
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<a href="https://images.theconversation.com/files/164638/original/image-20170410-29365-my2tcd.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/164638/original/image-20170410-29365-my2tcd.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/164638/original/image-20170410-29365-my2tcd.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=529&fit=crop&dpr=1 600w, https://images.theconversation.com/files/164638/original/image-20170410-29365-my2tcd.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=529&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/164638/original/image-20170410-29365-my2tcd.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=529&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/164638/original/image-20170410-29365-my2tcd.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=664&fit=crop&dpr=1 754w, https://images.theconversation.com/files/164638/original/image-20170410-29365-my2tcd.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=664&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/164638/original/image-20170410-29365-my2tcd.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=664&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Parents use toys and mobile phones to distract a child from a medical examination.</span>
<span class="attribution"><span class="license">Author provided</span></span>
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<p><a href="http://www.sciencedirect.com/science/article/pii/S0305417913003288">Research also shows</a> lower anxiety is linked with quicker wound healing in children. Quicker wound healing means less medical intervention, and kids can get back to school and the playground faster.</p>
<p>No-one likes to think of their child sustaining an injury. But it can be handy to have a few tips up your sleeve if you do need to take your child for medical treatment, for yourself as much as for your child. </p>
<h2>What to do</h2>
<p>• Distract your child early on in the treatment (toys, food, music, pictures, TV, conversation, nursing, pacifier. You know what works best)</p>
<p>• Be close by. Reassuring touch tells them you are with them</p>
<p>• Some kids like to watch, others don’t. If they want to, let them but also keep encouraging distracting behaviour</p>
<p>• Encourage your child to do deep breathing exercises. This is something you can do together to slow down your and your child’s heart rate</p>
<p>• Remain calm and confident, even if you find the treatment difficult to watch</p>
<p>• Say things like “look at me and squeeze my hand,” “who is that on the TV?,” “can you tell the nurse what we are going to do after this?,” “remember when we went to the park and […],” and “show me how you do deep breathing”.</p>
<h2>What to avoid</h2>
<p>• Scaring them with how painful the medical treatment will be or “how bad it looks”</p>
<p>• Criticising their behaviour </p>
<p>• Minimising their experience (“you’re okay,” “almost done”)</p>
<p>• Encouraging the pain (“I know it hurts a lot”) </p>
<p>It’s common for parents to feel upset themselves following a young child’s injury. All parents struggle with anxious and guilt-ridden thoughts about their child’s health from time to time, so it can help to treat yourself with kindness and remind yourself you’re doing what you can to give your child the best medical care.</p>
<p>It helps to stay focused on helping your child during stressful medical treatment, rather than worry about the injury severity. If you’re concerned about your own coping during the treatment, invite a second adult along to support your child if you need to take a break. </p>
<p>You can also seek further support through talking with your child’s nurse or social worker, or your local doctor.</p><img src="https://counter.theconversation.com/content/75397/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Erin Brown receives funding from Children's Hospital Foundation.</span></em></p><p class="fine-print"><em><span>Justin Kenardy receives funding from Children's Health Foundation Queensland</span></em></p>A study found parents who were less distressed were more able to support their child during a medical procedure, and this increased the child’s ability to cope and decreased child distress and pain.Erin Brown, Ph.D. Candidate, The University of QueenslandJustin Kenardy, Clinical psychologist; Professor of Clinical Psychology; Deputy Director of the Recover Injury Research Centre, The University of QueenslandLicensed as Creative Commons – attribution, no derivatives.