Infants, toddlers, school-aged children, and teenagers all show pain in different ways.

• Infants in pain move less. They may become irritable and cry frequently. Their appetites decrease. They may cry out if moved or touched. Parents know their infants well, and should advocate for appropriate medication if their infant is in pain.

• Preschoolers may become irritable, cry, or strike out if they are in pain. They may lose all interest in playing. Their breathing can become rapid and shallow. They might not be able to describe the pain in words, but may point to what hurts if asked, “Where is your owie?”

• School-aged children will be able to tell you when they are hurting. You can ask your child where it hurts and how much it hurts. Nurses should have sheets with a series of faces (from smiling to crying) that may help your child explain the amount of pain he is feeling. Some young children won’t express pain because they fear that they will “get a shot.” Take time beforehand to explain that they can get pain medicine through an IV line or by mouth and that the medicine will make them feel better, not worse.

• Teenagers react to pain like adults do. They may become angry, withdraw, have disrupted sleep and appetites, or become quiet and still. Any behavior changes should be investigated. Teens may not report pain for fear of taking drugs or becoming addicted. Reassure your teen that patients rarely become addicted to pain medication given for short periods of time in the hospital. Accurate, factual information about pain and pain control is crucial for adolescents.