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Unlike with older children, crying isn't always a reliable pain indicator in babies. That's because crying is a baby's way of expressing a whole host of needs. Here are signs that a baby may be in pain.
Changes in crying patterns. A baby's distressed cry sometimes, but not always, sounds different from ordinary crying. Changes in your baby's behavior can also be a tip-off. For example, crying that can't be soothed with a bottle, diaper change, or cuddling could signal pain. Also, a calm baby who becomes unusually fussy could be in pain.
Crying while nursing. Sucking can create pressure in the ears. The baby who cries while nursing could very well have a painful ear infection.
Prolonged, intense crying, often at the same time each day. This behavior is common with colic, which occurs in infants due to abdominal pain. It often starts at the age of 2 weeks, peaks at 6 weeks, and then gradually declines.
Crying and drawing the legs up to the abdomen. Your baby could have colic or a serious medical condition.
Withdrawing. Chronic pain can sap a baby's energy, causing him or her to become still, quiet, and to avoid eye contact.
Symptoms of Pain in Toddlers
Fortunately, at this age, children in pain can talk, if only to say, "Owie, owie, owie!" They will often also clutch the part that hurts. Pulling or rubbing the ear is common in toddlers and although it can sometimes indicate ear pain, it is more often associated with teething or simply habitual. Suspect an ear infection if your child has had cold symptoms or a fever and begins to tug at the ear suddenly.
Symptoms of Pain in Children and Adolescents
Chronic or recurrent pain is common in children and adolescents. Research has shown that as many as 30% to 40% complain of pain at least once a week. Consult your child's health care provider to determine the cause and to get treatment.
Acute abdominal pain. Pain that comes on suddenly can be caused by viral infections or by something more serious like appendicitis. If your child’s pain seems to be localized to the right of the belly button and is accompanied by nausea, vomiting, and desire to stay very still, she should be evaluated for appendicitis.
Recurrent stomachaches and headaches. A stomachache that goes away after a bowel movement could signal a problem with constipation or, less often, inflammatory bowel disease. Daily abdominal pain without nausea, vomiting, or diarrhea could be a special form of migraine, or could fall under the category of chronic recurrent abdominal pain, a common but frustrating complaint in children. Headaches are often associated with a viral illness. But those that occur frequently, often around the same time of day, or accompanying a girl’s menstrual period, and cause your child to be nauseous or sensitive to light could be migraines. Recurrent body aches, usually along with trouble falling or staying asleep, could mean your child is depressed or anxious. Both conditions are often underdiagnosed in children and are known to trigger or increase pain.
Chest pain. Chest pain that comes and goes, and can be reproduced by pressing on the chest, can be caused by muscle strain or inflammation of the rib cartilage and often occurs after your child takes up a new sport, increases physical activity, or experiences muscle tension due to emotional stress. Chest pain following an injury could indicate a broken rib or collapsed lung. Persistent chest pain is less common and could mean your child has asthma or an infection, such as pneumonia. Rarely is chest pain in otherwise healthy children caused by heart problems. However, if your child’s chest pain is accompanied by dizziness, shortness of breath or fainting, especially with exercise, bring him to the doctor for evaluation.