Children's & Toddler's Signs of Pain

What is pain?

Throughout your child’s body there are millions of nerve fibres, some of which end in pain receptors called nociceptors. These nerve fibres are constantly telling your child’s brain what is going on in their body and their environment.¹

When your little one is ill or hurt, the nociceptors detect the tissue damage and transmit pain signals up the spinal cord and to the brain.²

At the same time, tissues around the affected area release chemicals called prostaglandins. When prostaglandins are released, they make nearby nerves very sensitive to pain and make these pain signals stronger.³

Pain caused by damage to the body’s tissues is sometimes referred to as nociceptive pain.⁴ Ask your doctor or pharmacist if you need information about other types of pain.

Why do children feel pain?

Pain is the body’s way of telling us that something, somewhere needs some attention.⁵

For example, if your child sprains an ankle, the pain tells them that they’ve hurt something and it needs to be looked at. They can then let you know.

Why do some children feel more pain than others?

Each person has their own individual tolerance for pain. Some children (and many adults) have very high pain thresholds, while others have a lower tolerance of pain.⁶

One reason for this is perception. The brain works by association, so if a child’s had a particularly painful experience in the past, their brain may link any future pain with this experience. As a result, they may find it more difficult to cope with the new pain.⁷

Pain thresholds are also affected by emotions. If your child is feeling worried, their threshold may be lower. On the other hand, strong emotions, such as excitement or fear, can help to reduce the intensity of the painful sensation.⁸

How do I know if my child is ill?

Before your child is able to speak, it can be hard to know exactly why they’re upset. Are they in pain or discomfort? Or is it something else?

Here are some of the signs of illness to look out for in your baby or toddler.

Your newborn or toddler could be ill if he or she:

• Has unusual cry sounds⁹
• Is irritable¹⁰
• Is off their food⁹
• Is vomiting (especially if this is unusual)⁹
• Has frequent diarrhoea¹⁰
• Looks flushed, feels hot¹⁰
• Has a temperature above 38°C⁹
• Is pale⁹
• Is breathing noisily and has a hoarse cough¹⁰
• Is unusually quiet⁹
• Is more sleepy than usual⁹.

If you feel worried or concerned about any of your child's symptoms, always consult with your doctor. If it is a medical emergency, dial 000.

Always read the label and follow the directions for use. Incorrect use could be harmful.

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References:

1. Inquimbert, P. and Scholz, J. (2011) Pain. In Brady, S. et al. Basic Neurochemistry, Eighth Edition. Elsevier, Amsterdam.
2. Todd, A.J. (2007) Nociceptive Circuitry in the Spinal Cord. In Schmidt R., Willis W. (eds) Encyclopedia of Pain. Springer, Berlin, Heidelberg.
3. Grubb, B.D. (2007) Inflammatory Nociceptor Sensitisation, Prostaglandins and Leukotrienes. In Schmidt R., Willis W. (eds) Encyclopedia of Pain. Springer, Berlin, Heidelberg.
4. Schmidt, R. and Willis, W. (2007a) Nociceptive Pain. In Schmidt R., Willis W. (eds) Encyclopedia of Pain. Springer, Berlin, Heidelberg.
5. Prescott, S.A. and Ratte, S. (2017) Somatosensation and Pain. In Conn, P.M. Conn's Translational Neuroscience. Academic Press.
6. Chen, A.C.N., et al. (1989) Human pain responsivity in a tonic pain model: psychological determinants. Pain 37: 143-160.
7. Mohd Din, F.H., et al. (2016) Association between pain catastrophising and musculoskeletal disorders is modified by past injuries in Malaysian military recruits. Occupational and Environmental Medicine 73: 429-434.
8. Rhudy, J.L., et al. (2006) Emotional modulation of spinal nociception and pain: The impact of predictable noxious stimulation. Pain 126: 221-233.
9. Morley, C.J., et al. (1991) Baby Check: a scoring system to grade the severity of acute systemic illness in babies under 6 months old. Archives of Disease in Childhood 66: 100-106.
10. Dewar, J.C., and Dewar, S.B. (2015) Common Acute Infections in Children. In South-Paul J.E., et al. (eds.) Current Diagnosis & Treatment: Family Medicine. McGraw-Hill, New York.
11. Hall, K.L. and Zalman, B. (2005) Evaluation and Management of Apparent Life-Threatening Events in Children. Am Fam Physician 71: 2301-2308.