BY: Dr. Rebecca Pillai Riddell

 Experiencing quick pain from needles and other medical procedures is an important part of being healthy. Knowing that you are facing something painful, no matter how short-lived, often makes both adults and children scared and distressed.

 We are learning that not managing children’s medical procedure-related pain can have consequences long after the pain from the procedure has gone away. Undermanaged childhood pain can lead to children growing up into adults that are scared of medical settings and the wonderful health professionals who are there to make us healthier. These fears from childhood can make people less likely to go see health professionals in the future which can seriously impact their healthcare. Moreover, we also know that the more scared a child is before a painful procedure, the more pain they may feel and will express after the painful procedure. 

 Over the years, my daughters have had to undergo painful medical procedures while being treated by physicians, dentists, and nurses. One would assume that being a pediatric pain scientist and a clinical psychologist would prevent my children from experiencing needless pain in medical settings.  Unfortunately, that has not always been the case. Witnessing my own children’s anxiety and pain responding first-hand has made me passionate to help empower all parents to prevent and manage pain using powerful psychological techniques that are easy to learn. 

 Below you will find a set of techniques that our lab has researched and been shown to work with young children. The best part about the ABCD’s of pain management is that it does not take any special training or equipment. It focuses on one of the most powerful tools for managing pain from procedures: YOU, the parent.

 Our lab created a quick mnemonic (ABCD) that reminds parents that they themselves need to stay calm, they need to make their child feel safe despite the pain and, when the time is right, they should use distraction to help their child get back to how they were feeling before the painful procedure.

• A: Assess your own anxiety. Parents’ distress leads to kids’ distress. It is important to convey to your child that you are calm and focused on supporting them.
• B: Belly breathing. Having a parent take a few deep breathes is great way to regulate their heart rate, reduce their stress, and focus on their child in the moment. It also models an important technique for your toddler and preschooler that they can use when they are older.
• C: Calm Close Cuddle.  Pain is a trigger for children to feel insecure and fearful. The best thing parents of young children can do is to bring their child close so that they can feel safe through being close to you and even hearing your calm heart rate and breathing. If your child isn’t a snuggler, then find a way to be close to your child without smothering them e.g. holding their hand.
• Distraction: This is a tricky one. While most parents know how to distract a child with car keys, a song, bubbles, funny faces, a story book, when the child is in pain timing is key. You need to wait until your child has passed the peak distress- around 30 seconds after the painful procedure has ended. If you do it too early, this may make your child even more distressed. If you try it and they get distressed, no problem! Simply go back to the cuddling. 

These strategies represent a small (but mighty!) sampling of the strategies parents can use to reduce pain from procedures for their children. If you want to watch some short videos by parents or experts about how to manage pain, I would recommend going to these amazing ‘Made in Canada’ websites led by scientists who work with parents and professionals to get the right evidence into the right hands: Helping Eliminate Pain in Kids and Adults-  http://phm.utoronto.ca/helpinkids/resources.html and It Doesn’t Have to Hurt  http://itdoesnthavetohurt.ca/.