Delivering transformative action in paediatric pain: a Lancet Child & Adolescent Health Commission

© The Lancet Child & Adolescent Health

Pain is a feeling every child and adolescent, will experience in their lives. Yet, unrecognised, undertreated, or poorly managed pain in childhood can have long-lasting negative consequences such as chronic pain, disability and distress. Even though there are several tools, expertise, and evidence available to handle childhood pain more successfully, pain is too often silenced and relief too infrequently given. Therefore, it is time for a change. The Lancet Child & Adolescent Health Commission calls for delivering transformative action in paediatric pain and presents four goals as milestones to do so:

  1. To make pain matter:

Multiple evidences prove frequent failings of adequate and appropriate pain relief in medical practices and concurrently visualizes the indifference with which pain is considered in many settings. To acknowledge the need for a strong investment in a social science research base for paediatric pain is one step forward towards a better understanding and handling of the social and cultural context of pain.

  1. To make pain understood

Despite ongoing progress in the exploration and understanding of nociception and pain perception, there are still blank spots that, until now, have remained unclear. Therefore, greater investment in larger international birth cohort studies with incorporated valid pain-related measurements and the consideration of the whole biopsychosocial model has become mandatory.

  1. To make pain visible

The Commission demands the assessment of pain in every child as the methods to do so exist but nevertheless need to be optimised. Additionally, the Commission advises to set focus on outcomes that are valuable to patients, rather than to highlight those that are important to researches and clinicians.

  1. To make pain better

In order to do so, we need to expand our knowledge of treatment approaches to a more holistic level, including psychological, pharmacological and physical interventions. Therefore, greater investment in research and coordinated approaches are essential to meet the needs of affected children and adolescents.

Most importantly, all types of pain, including the procedural pain, that many preterm born babies experience, are discussed and acknowledged in the article. The Commission voices the importance of cross-sector collaboration in order to achieve the effective and valuable change that is needed to improve the quality of life of children and adolescents with pain.

More about the Commission and the related content can be found here:

Read about EFCNI’s statement of standard in terms of minimising stress and pain for all infants in neonatal and paediatric units: