Children's Pain - The Facts

Children's Pain - The Facts

Parents are often the best judges of their child's pain. Listen to what they tell you and watch what they do. If worried or in doubt about your child's pain, talk to your local doctor or if you are in hospital, a nurse or doctor.


Key points about children's pain

  • as parents you are often the best judge of your child's pain
  • listen to what your child is telling you and watch how they are behaving
  • if you are worried or in doubt about your child's pain, talk to your local doctor, or if you are in hospital, a nurse or doctor
  • if you are unsure about whether or not to give any medicine for your child's pain, it is best to get advice from your doctor or pharmacist

What is pain?

Young tamariki or tamariki who are sick cannot always tell us exactly what they are feeling. This can be quite upsetting for parents and whānau who may feel confused about what their child is experiencing. Parents know their child's usual reactions and behaviours but sometimes pains and fear may change these reactions.

Many things affect your child's experience of pain:

  • your child's age
  • your child's beliefs and understanding about the cause of the pain
  • your child's beliefs in their ability to cope
  • your child's previous experiences with pain and how they have seen other people deal with pain
  • your child's learned responses to pain

How long does pain last?

Acute pain

The term 'acute pain' refers to pain that is not long-lasting. The pain may be caused by an operation, injury, illness, or medical procedure. Depending on what has caused the pain, the pain may last a few seconds (for example, a needle) through to a few weeks or months (for example, following an injury). Some pain from an operation is normal and is a part of the whole healing process. Medicines can help lessen acute pain. You can also help your child with acute pain by using methods such as relaxation and distraction techniques.

Persistent or chronic pain

Persistent or chronic pain is any pain that lasts for a longer period of time, usually longer than 3 months. This pain can be persistent (continuing), or come and go at different times. It is sometimes difficult to find a cause for persisting pain; however, there are treatments and special programmes that can help your child cope better with this type of pain.

See the KidsHealth page on chronic or persistent pain to learn more

How do you know your child is in pain?

It is not always easy to know how much pain your child is experiencing but listening to what they say and watching what they do can help give you a better idea. 

Things that can show that your child is in pain include:

  • crying
  • facial changes or pulling a face such as a grimace or frown
  • changes in sleeping or eating patterns
  • becoming quiet or withdrawn
  • screaming
  • refusing to move
  • an overall change in their function

Remember that changes in a child's behaviour can also happen because they are scared or frightened.

Some tamariki may tell us they are sore or hurting but may find it hard to say how much.

There are some tools you can use to help with this. 

Pain scale and scoring tool

See the Faces Pain Scale | Revised (FPS-R) for children over 3 years (PDF, 194KB).

Screenshot of the faces pain scale

This will involve asking your child to point to the face that shows how much hurt they are feeling from 'no pain' on the left through to 'very much pain' on the right. You can tell staff which number face your child has pointed to and that will help them to know how your child is feeling.

There is another tool to assess pain in young tamariki or those with a developmental disability.

See the Modified FLACC scoring tool (PDF, 238KB).

For each of the categories, select a score of either 0, 1, or 2 and add them up for a score out of 10. This number will help you to explain your child's pain to staff.


Starship Foundation and the Paediatric Society of New Zealand acknowledge the cooperation of The Children's Hospital at Westmead, Sydney Children's Hospital at Randwick, and Kaleidoscope - Hunter Children's Health Network in making this content available to patients and families.

This page last reviewed 23 July 2020.

Call Healthline on 0800 611 116 any time of the day or night for free health advice when you need it