Evaluating pain in a child

When a child is in pain, his or her parents usually know it. However, pain can be difficult for a child to describe. An older child may be able to describe the pain as sharp or cramping or tell whether the pain comes and goes (intermittent). When a young child is in pain, the signs sometimes can be hard to recognize. Watch for changes in how your child acts.

The signs listed below may help you decide whether your child's pain is mild, moderate, or severe. A child with severe pain will have more of these behaviors, the behaviors will be more constant, and you will be less able to comfort the child. Look for:

• Changes in usual behavior. Your child may eat less or become fussy or restless.
• Crying, grunting, or breath-holding.
• Crying that can't be comforted.
• Facial expressions, such as a furrowed brow, a wrinkled forehead, closed eyes, or an angry appearance.
• Sleep changes, such as waking often or sleeping more or less than usual. Even children in severe pain may take short naps because they are so tired.
• Body movements, such as making fists, guarding a part of the body (especially while walking), kicking, clinging to whoever holds him or her, or not moving.

A child between the ages of 18 months and 3 years may complain of pain or tell you he or she is not feeling well.