What is pain management in babies?

Pain management in babies means understanding when your baby is in pain and then helping them to feel better with medicines or other pain reducing techniques. If your baby seems very unwell or the pain doesn't go away, contact a doctor.

How do I know if my baby is in pain?

It can be hard to know if a baby is in pain, because they can't tell you how they feel. There are signs that can help you recognise when your baby is in pain. For example, they may:

• cry or whimper and be unable to settle
• be tense, with clenched fists and may keep their arms and legs close to their chest
• be fidgety or agitated
• have a disturbed sleep-wake schedule
• appear pale or flushed
• frown or change their facial expression

What causes pain in babies?

If your baby is unwell, injured or has had surgery, they may be in pain.

Teething can also be painful, even though it is a normal part of your baby's development.

Pain during medical procedures

In the first year of life, most babies will have several medical procedures. These may cause minor pain and distress but are important for their health.

In the first 3 days of your newborn's life, a small amount of blood will be taken from their heel for the newborn screening test (or 'heel prick test') to check for rare but serious conditions. You will also be offered a number of vaccinations to help prevent serious contagious diseases.

If your baby is born prematurely or with a medical problem, they may need additional procedures such as:

• blood tests
• feeding tubes
• intravenous (IV) lines

While these procedures may cause your child some pain in the short-term, the aim is to ensure their long-term health and wellbeing.

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When should my baby see a doctor?

As a parent, you know your child best. If your baby sounds, looks or behaves in an unusual way and you are worried that they may be in pain, seek medical advice.

It's important to see a doctor if your baby:

• seems to be unwell
• is still in pain after a few hours
• is in severe pain

A doctor can examine your baby to find out what is causing their pain and for signs such as an unusual heart rate or blood pressure.

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How can I help manage my baby's pain?

There are several ways you can help soothe your baby when they're in pain.

Self-care at home

You are one of the greatest sources of comfort to your baby. Just being close to them may have a calming effect.

Some other pain reducing techniques include:

• talking or singing to your baby
• swaddling your baby
• breastfeeding or offering your baby a dummy
• stroking your baby's head and back softly
• 'kangaroo care' (skin-to-skin contact between you and your child, where you are both covered by a blanket)
• placing them on their side with their head supported and their arms and legs tucked in

If your newborn undergoes a painful procedure, their doctor or nurse may suggest you:

• breastfeed your baby
• hold your baby skin-to-skin
• give them a sugar (sucrose) solution

These techniques are proven to have a calming and pain-relieving effect on newborns.

Medicines for pain relief

You can give your baby medicines such as paracetamol and ibuprofen for short-term relief of symptoms such as pain or fever. While they won't treat the cause of the pain, they can make your baby feel and sleep better.

• Paracetamol may be given from 1 month of age, every 4 to 6 hours in the correct dosage based on your baby's age and weight, but no more than 4 times in 24 hours.
• Ibuprofen may be given from 3 months of age, every 6 to 8 hours in the correct dosage based on your babies weight, but no more than 3 times in 24 hours. If your child has a bleeding disorder, do not give them ibuprofen.
• Never give your child aspirin, unless specifically instructed by your doctor.

Read the dosing instructions on the pack carefully. It's important to make sure that you give your child the correct dose of pain medicines. The amounts your baby needs depends on their weight and the strength of the product you buy. The strength (concentration) of the medicine can vary from product to product.

Giving your child too much medicine or giving it too frequently could be harmful. Ask your pharmacist if you are unsure of the correct dose of medicine for your baby.

See a doctor if your baby or child needs paracetamol or ibuprofen for more than 48 hours.

Resources and support

• The Sydney Children's Hospitals Network provides information about pain in babies and children.
• The Royal Children's Hospital Melbourne offers tips on reducing pain during medical procedures.
• If your baby seems to be in pain, call the Pregnancy, Birth and Baby call service to speak with a maternal child health nurse. Video call is a free service and is available 7am to midnight (AET), 7 days a week (including public holidays).

Do you prefer to read in languages other than English?

• The Royal Children's Hospital Melbourne provides information in several community languages about pain-relieving medicines for babies and children.

Looking for information for Aboriginal and/or Torres Strait Islander people?

• Find an Aboriginal Community Controlled Health Organisation (ACCHO) in your area.