Advances in dealing with children's pain

November 08, 1998|By Susan Ferraro | Susan Ferraro,NEW YORK DAILY NEWS

In the memoir "Boy," Roald Dahl wrote of how, when he was very small, his tonsils were pinched out, in the doctor's office, without benefit of any anesthetic.

And this reporter's own mother never forgot the horrifying pain she endured in childhood when a doctor lanced her middle ear without anesthetic.

Pain hurts more when you are small, doctors say. Trauma triggered by the sting of a needle or a cut being sewn up without anesthetic can make kids distrustful of both parents and doctors, and even set up a lifelong aversion to medical procedures.

Though doctors are learning more about kid-size pain, a booster shot or vaccination can still turn routine visits to the pediatrician into full-scale battles. But coming to the rescue are new methods to prevent even routine pain.

A numbing cream called EMLA, made of lidocaine and prilocaine, is available in a "peel and stick" topical form. It can be used for kids more than a month old to dull the pain of needle sticks. Available by prescription, it is applied at home, in advance of an office visit.

More pediatric surgeons are using pain medication to ease discomfort before and after kids' surgery - a big step, as for years the official attitude was that giving heavy-duty painkillers to small people was not safe.

In four or five years, patches of tiny "microneedles" may deliver insulin and some forms of chemotherapy painlessly, say researchers who are developing them at Georgia Tech. They could especially benefit kids and diabetics who need frequent ,, injections, though hypodermics would still be needed for medicine that goes directly into muscle or blood.

The microneedle patches - hundreds of small needles just 10 to 20 microns long (about 1/50th of a millimeter) and too short to reach nerve endings - would deliver medicine subcutaneously, just under the very top layers of skin.

Also, newborn needle sticks - blood taken from babies' heels to test liver function - may soon be a thing of the past. A study of 2,441 infants led by pediatricians at Mount Sinai Medical Center in New York showed that a no-needle, non-invasive color monitor for assessing skin tone accurately identifies those babies developing bilirubin jaundice.

It can also monitor them during treatment.

The device is called Colormate TLc-BiliTest, is FDA-approved and is sure to bring comfort to babies - and their frantic parents, who, until now, have had to stand by helplessly as their babies were poked.

Tantrum-avoidance tips

Tips for getting through a doctor's office visit without a tantrum:

* Find out what the exam includes, and if any of it will hurt. If there are shots, ask what kind - under the skin or in the muscle.

* Ask the child what is most scary, and tell the doctor's staff.

* Ask - in advance - if a numbing agent can be used.

* Prepare kids - keeping them in the dark won't make it hurt less.

* Bring a distraction - a stuffed animal to hug, a book, a toy.

* Keep in physical contact with your child, and keep talking to him or her.

* Promise to do something fun after the visit.

Pub Date: 11/08/98

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