What Parents Can Do
Doctors are increasingly aware of simple techniques that make a big difference. But parents may have to push to make sure physicians use them.
For Routine Checkups
A few days before your appointment, call your pediatrician to ask about pain-free strategies. For shots and blood draws -- most children have about two dozen before kindergarten -- there are several options to make them less painful and scary (see "Take the Sting Out of Shots"). Also ask how you can help the doctor or nurse by comforting your child using techniques like swaddling, breastfeeding, distraction, and proper positioning.
In Case of Common Infections
With ailments like ear infections or strep throat, it often takes days for antibiotics to relieve the painful symptoms. Ear infections are particularly distressing for babies (imagine suddenly descending in an airplane and not being able to pop your ears), yet studies have found that many are never given prescription anesthetic ear drops like Auralgan or even acetaminophen. Since most over-the-counter children's pain medicines underestimate the most effective dose (an attempt to err on the side of caution, in case families make a mistake), ask your doctor to calculate how much you can give your child based on his weight. For at least the first day of the illness, give medicine on a regular schedule.
During Hospital Procedures
If your child needs minor surgery, a fracture setting, or a bone-marrow biopsy, ask if the hospital has a "pediatric sedation team." As a medical student, I once pushed a large needle through a baby's pelvis to extract bone marrow, using no anesthesia. Today, there's no excuse for that. The sedation team can give your child short-acting medication to make him fall asleep and feel little pain, without needing general anesthesia. Certain drugs can even erase short-term memory, so he'll forget the entire procedure. Immediately after surgery, some hospitals use nurse- or parent-controlled analgesia, which releases small pulses of precisely dosed narcotics like morphine through an IV. (For decades, doctors avoided using narcotics in babies, but we now know they're safe when used properly.) Request that your doctors give you a clear plan to manage your child's pain after you go home.
Like many parents, I wish that all children could be spared from harm. Of course, that's an impossible dream. But the avoidable pain of needles in the emergency room or pediatrician's office is certainly a good place to start.