How do I know if my baby is in pain?

It can be difficult to know if a baby is in pain since they can’t directly communicate how they are feeling, but there are signs that can help you recognise when they are in pain. For example, if a baby is in pain:

• they may cry or whimper, and be unable to settle
• they may be tense, with clenched fists, and may keep their arms and legs close to their chest
• they may be fidgety, agitated or have an unclear wake/sleep schedule
• they may be pale, flushed or sweaty
• they may shut their eyes tightly, furrowing their eyebrows, or have larger than normal pupils

As a parent, you know your child best — if you notice your baby sounds, looks or behaves in an unusual way, and you are worried they may be in pain, seek medical advice. A doctor or baby health clinic can check for other signs that your baby might be unwell, such as an unusual heart rate or blood pressure.

Common pain

In the first year of life, your baby will undergo several procedures. These cause minor pain and distress, but they are very important since they help keep your baby well.

In the first 3 days of your newborn’s life, a small amount of blood will be taken from their heel. This newborn screening test (or 'heel prick test') is done to check for rare but serious conditions. You will also be offered a number of immunisations, which help prevent some serious contagious diseases.

If your baby is born premature, or with a medical problem, they may also require blood tests, feeding tubes, IV lines or surgery to help them perform all the tasks our bodies do naturally. While these procedures may cause your child some pain in the short term, the aim is to ensure their long-term health and wellbeing.

How can I help my baby in pain?

You are one of the greatest sources of comfort to your baby, and your very presence may have a calming effect.

Some established pain-reducing techniques include:

• letting your baby hold your finger
• talking or singing to your baby
• swaddling your baby in the fetal position
• breastfeeding
• nappy changing
• offering them a dummy
• tactile soothing (stroking the head and back softly)
• 'kangaroo care' (skin-to-skin contact between parent and child, both covered by a blanket)
• holding your baby with both hands (to provide a feeling of security)
• taking your baby to a dark, quiet space

If your newborn undergoes a painful procedure, their doctor or nurse may suggest you breastfeed or hold your baby skin to skin if possible, or give them sugar (sucrose) solution. These techniques are proven to have a calming and pain-relieving effect on infants.

Video provided by Sharing Knowledge About Immunisation.

When can I give pain medicine?

You can give your child medicines such as paracetamol and ibuprofen for short-term relief of fever-like symptoms. While they won’t make the cause of the pain go away, they will make your baby feel and sleep better.

• Paracetamol may be taken from 1 month of age, every 4 to 6 hours in the correct dosage (based on age and weight), but no more than 4 times in 24 hours.
• Ibuprofen may be taken from 3 months of age, every 6 to 8 hours in the correct dosage (based on age and weight), but no more than 3 times in 24 hours. If your child has a bleeding disorder, do not give them ibuprofen.
• Never give your newborn aspirin, unless specifically instructed by your doctor.

Where to get help

If your newborn has been taking paracetamol or ibuprofen for 48 hours but is still unwell, seek medical advice.

Ask your pharmacist if you are unsure of the correct dose of medicine for your baby.

If you have given your child too much ibuprofen or paracetamol, call the Poisons Information Centre (13 11 26) immediately or take them to your nearest hospital emergency department.