Don’t pass on paediatric pain

By Timothy Cocks Science and the world 07 Jan 2014

Why is pain in children ignored?

From Oxford University Press’s Blog

It is hard to believe that in the mid 1980s it was standard care, even in many academic health centres, for infants to have open heart surgery with no anaesthesia but just a drug to keep the infant still.

This practice was blown out of the water by a courageous mother, Jill Lawson, who against great resistance, pushed to publicize the lack of anaesthesia during open heart surgery that her son, Jeffrey Lawson, had undergone at DC children’s hospital. After dozens of letters and requests for a review of the policy and many condescending rebuffs, the Washington Post published her story. All hell broke loose. There were dozens of news stories because every mother knew that babies feel pain. How could health professionals be so stupid?

So why is pain in children and youth ignored? Is it because children can’t speak out for themselves and when they cry it is dismissed because “Children always cry”? Because children as a group are not valued? Does it go unchallenged by parents because those parents believe that the doctors would of course relieve the pain if they could? Or is it the case that advocates for children’s pain have simply not been effective? Or is pain just dismissed as “a symptom”, or is seen as unimportant by health providers? 

Why indeed?

– Tim Cocks

comments

  1. davidbutler0noi

    Hi Tim,

    Thanks for bringing up this topic.

    I thinks it is a “yes” to all your questions. Older therapists like myself quiver at such stories as we were in clinics at that time. Swafford and Allen’s 1968 statement “Paediatric patients seldom need relief of pain after general surgery . They tolerate discomfort well” sums up the prevailing view for the following decades.

    Things have changed and are still changing of course with much thanks to the International Association for the Study of Pain (IASP). One critical area of research is on the long term consequences of untreated pain. The Taddio et al (1997) study is enlightening – compared to uncircumsized infants, circumsized infants displayed stronger pain responses to subsequent 4 and 6 month immunisation. However some anaesthetic cream at circumcision will stop the enhanced pain responses.

    David Butler

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