Skip to main content

Main menu

  • Home
  • COVID-19
    • Articles & podcasts
    • Blog posts
    • Collection
    • News
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • Classified ads
  • Authors
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
  • CMA Members
    • Overview for members
    • Earn CPD Credits
    • Print copies of CMAJ
    • Career Ad Discount
  • Subscribers
    • General information
    • View prices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
    • Trousse média 2021
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN

User menu

Search

  • Advanced search
CMAJ
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN
CMAJ

Advanced Search

  • Home
  • COVID-19
    • Articles & podcasts
    • Blog posts
    • Collection
    • News
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • Classified ads
  • Authors
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
  • CMA Members
    • Overview for members
    • Earn CPD Credits
    • Print copies of CMAJ
    • Career Ad Discount
  • Subscribers
    • General information
    • View prices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
    • Trousse média 2021
  • Visit CMAJ on Facebook
  • Follow CMAJ on Twitter
  • Follow CMAJ on Pinterest
  • Follow CMAJ on Youtube
  • Follow CMAJ on Instagram
News

Poorly managed childhood pain can have lifelong consequences

Alison Motluk
CMAJ July 08, 2019 191 (27) E771-E772; DOI: https://doi.org/10.1503/cmaj.109-5768
Alison Motluk
Toronto, Ont.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Tables
  • Responses
  • Metrics
  • PDF
Loading

Does it matter if an infant feels the pinch of an injection? Or if a preemie feels the abrasion of a feeding tube? Not so long ago, it was widely believed that the very young couldn’t even feel pain. But a new campaign is warning that unmanaged pain in early childhood not only hurts, it can have long-lasting undesirable effects and needs to be tackled more effectively.

“There’s this belief that pain will toughen you up and you’ll get used to it,” says Christine Chambers, Canada Research Chair in Children’s Pain at Dalhousie University. “But the reverse happens. There’s a lot of science showing sensitization, and that poorly managed pain early in life actually causes you to feel more pain later.”

Chambers is spearheading a campaign, Solutions for Kids in Pain, dubbed SKIP, which launched in April. It aims to bring together families, clinicians, researchers and health system managers to help ensure children’s pain is managed appropriately.

“There is a pretty substantive literature looking at the long-term effects of poorly managed pain in babies, especially preterm babies,” says Chambers. Research suggests unchecked childhood pain can delay healing, alter brain development, lead to chronic pain and increase the risk of opioid addiction later in life.

Pediatric pain has historically been managed poorly compared to adult pain, says Chambers. Although we have moved on from the dark days of not even anesthetizing babies undergoing surgery, children’s pain is still undertreated. A 2011 paper in CMAJ, for instance, found that two-thirds of children in Canadian hospitals underwent painful procedures without appropriate pain management.

Part of the challenge of pain management in children is communication. Many patients are pre-verbal so their need for pain relief is difficult to assess. But another part is not translating scientific findings into practice, says Chambers. “We have solutions that we know work to reduce pain, but often they just aren’t used.”

Figure1

A campaign to manage pain better in children was recently launched in Canada.

Image courtesy of iStock.com/kckate16

Breastfeeding is a good example. “Breastfeeding during painful procedures is not just comforting; science has shown that it’s a proven pain reliever,” says Chambers. But sometimes health professionals discourage it, expressing concern that babies will start associating eating with pain.

“There’s not as much emphasis on pain management in kids,” agrees Dr. Deepa Kattail, a pediatric anesthesiologist and pain researcher at McMaster University. “I think, overall, people are nervous.” Even in children’s hospitals, Kattail says, when kids are sent for blood work, phlebotomists will often not use anesthetic cream for fear it will be absorbed at toxic levels, and saying it’s outside their scope of practice.

Breastfeeding, anesthetic cream, sucrose, distraction techniques, relaxation strategies, seating positions — all have been shown to mitigate pain, says Chambers, but they are not always employed when they should be.

“It speaks to the challenges of getting science out of the medical journals, out of the medical conferences, and into the hands of people who can actually implement it,” says Chambers, pointing out that it can take as long as 17 years to get research to the front lines or practice. “In pediatrics, 17 years is too long. It’s a whole generation of kids who miss out on knowledge.”

According to Doug Maynard, associate director of business development at Children’s Healthcare Canada, a nonprofit that has teamed with SKIP, hospitals must be more engaged at the systems level. Good pediatric pain control has to become part of the accreditation process, he says. “You have to have hospital administrators’ buy-in.”

Dr. Fiona Campbell, director of the chronic pain clinic at The Hospital for Sick Children, agrees that accreditations, such as ChildKind International, can help put pressure on institutions to do the right thing. But she thinks more is needed to change how Canada addresses pain management in general.

In April, the federal government launched the Canadian Pain Task Force to investigate how the country is doing on managing pain and if it can do better. Campbell, who is president of the Canadian Pain Society, is cochair of the task force. She points out that the Canadian economy loses $60 billion every year to the direct and indirect costs of pain. We also lose lives; people in chronic pain have double the risk of dying by suicide. “We’ve been pushing for a long time to get a national pain strategy,” says Campbell.

Footnotes

  • Posted on cmajnews.com on June 18, 2019.

PreviousNext
Back to top

In this issue

Canadian Medical Association Journal: 191 (27)
CMAJ
Vol. 191, Issue 27
8 Jul 2019
  • Table of Contents
  • Index by author

Article tools

Print
Download PDF
Article Alerts
To sign up for email alerts or to access your current email alerts, enter your email address below:
Email Article

Thank you for your interest in spreading the word on CMAJ.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Poorly managed childhood pain can have lifelong consequences
(Your Name) has sent you a message from CMAJ
(Your Name) thought you would like to see the CMAJ web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Poorly managed childhood pain can have lifelong consequences
Alison Motluk
CMAJ Jul 2019, 191 (27) E771-E772; DOI: 10.1503/cmaj.109-5768

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
‍ Request Permissions
Share
Poorly managed childhood pain can have lifelong consequences
Alison Motluk
CMAJ Jul 2019, 191 (27) E771-E772; DOI: 10.1503/cmaj.109-5768
Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Footnotes
  • Figures & Tables
  • Responses
  • Metrics
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • Canada’s long road to a vaccine injury compensation program
  • Health advocates want help handling online harassment
  • Time for more effective masks?
Show more News

Similar Articles

Collections

  • Topics
    • Pediatrics

Content

  • Current issue
  • Past issues
  • Collections
  • Sections
  • Blog
  • Podcasts
  • Alerts
  • RSS
  • Early releases

Information for

  • Advertisers
  • Authors
  • Reviewers
  • CMA Members
  • Media
  • Reprint requests
  • Subscribers

About

  • General Information
  • Journal staff
  • Editorial Board
  • Governance Council
  • Journal Oversight
  • Careers
  • Contact
  • Copyright and Permissions

Copyright 2021, Joule Inc. or its licensors. All rights reserved. ISSN 1488-2329 (e) 0820-3946 (p)

All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association or its subsidiaries.

To receive any of the resources on this site in an accessible format, please contact us at cmajgroup@cmaj.ca.

Powered by HighWire