Symptoms of pain in children

It can be a challenge to recognise the symptoms of pain in children. Is he really hurting, or am I overreacting? Does she really have headaches when the doctor can't find anything wrong?

Pain is a highly individual and complex experience. What follows is the advice of experts for reading symptoms of pain in your child.

Symptoms of pain in babies

Unlike with older children in pain, crying isn't always a reliable pain indicator in babies. That's because crying is a baby's way of expressing a whole host of needs. Here are signs that a baby may be in pain:

• Changes in crying patterns. A baby's distressed cry sometimes, but not always, sounds different from ordinary crying. Changes in your baby's behaviour can also be a tip-off. For example, crying that can't be soothed with a bottle, nappy change, or cuddling, could signal pain. Also, a calm baby who becomes unusually tetchy could be in pain.
• Crying while nursing. Sucking can create pressure in the ears. The baby who cries while nursing could very well have a painful ear infection.
• Prolonged, intense crying, often at the same time each day. This behaviour is common with colic, which occurs in infants due to abdominal pain; this often starts at the age of 2 - 3 weeks old, peaks at 6 weeks, and then gradually declines.
• Crying and drawing the legs up to the abdomen.Your baby could have colic. However, there are other more serious conditions to consider, such as intussusception (a condition where the bowel slides in on itself causing a blockage), constipation, reflux disease (indigestion), urinary tract infections and appendicitis to name a few. If your baby has this symptom, it’s best to seek medical advice to make sure it’s nothing more serious.
• Withdrawing. Chronic pain can sap a baby's energy, causing the baby to become still, quiet, and to avoid eye contact.

Symptoms of pain in toddlers

Fortunately, at this age, children in pain learn to talk, if only to say, "Ow, ow, ow!" They will usually clutch the part that hurts although they are not always that good at localising pain. Some toddlers will have a headache and point to their tummy. Pulling or rubbing the ear is common in toddlers when their ears hurt. This is often due to an ear irritation, wax, an object in the ear or an infection.

Symptoms of pain in children and adolescents

Chronic or recurrent pain is common in children and adolescents. Research has shown that as many as 30% to 40% complain of pain at least once a week. Consult your child's doctor to determine the cause and to get treatment.

• Acute abdominal pain. Your child may have appendicitis, a urinary infection, testicular torsion (a twisting of the testicle in boys), constipation or an anal fissure to name a few causes.
• Recurrent stomach-aches and headaches. A stomach-ache that often goes away after a bowel movement could signal a problem with constipation. A headache is often associated with a viral illness. Or, recurring headaches may also be due to migraines. Recurrent aches and pains, usually along with trouble falling or staying asleep, loss of interest in things, irritability and/or isolating behaviour, could mean your child is depressed or anxious. Both are often under-diagnosed in children and are known to trigger or increase pain.
• Chest pain. Chest pain that comes and goes can occur after your child takes up a new sport, increases physical activity, or experiences muscle tension due to emotional stress. Chest pain following an injury could indicate a broken rib or collapsed lung. Persistent chest pain is less common and could mean your child has an infection, such as pneumonia.