GOOD MEDICINE FOR CHILDREN'S PAINS : BAG OF TRICKS CAN HELP KIDS FIND RELIEF.

Byline: Cecelia Goodnow Seattle Post-Intelligencer

Being a kid can be a real pain. The most common childhood miseries - apart from injuries - are headache, tummy ache, the needle pokes of immunization, and those phantom limb pains known as ``growing pains.''

Leora Kuttner, a pediatric pain specialist and author of ``A Child in Pain,'' offers tips for harried parents:

Keep your own anxiety in check since it just adds to your child's distress. If your breathing is rapid and shallow, deliberately exhale to release tension.

Tell your child what's happening with his body and what steps will be taken to make the pain go away. Stay calm and use language that instills hope and courage. Remind your child that the pain will end.

Make physical contact with your child. Hold hands, stroke her arm or pat her back. Patting at a rate of twice a second seems to inhibit the small pain fibers of the nervous system, providing some relief.

Don't fuss too much or pile on sympathy. That increases children's absorption in the pain. Instead, give concrete ways to ease the distress, such as running a cut finger under cold water or using a Band-Aid to hide the sight of blood.

Try to gauge the severity of the pain. For children 4 to 8, try the poker-chip technique. Four red poker chips symbolize the pain. One means a tiny bit of pain, and four mean the most pain. Ask how many ``pieces of hurt'' she has.

Children 6 and older might instead use a ``pain thermometer,'' charting their sensations on a picture of a thermometer marked from 0 to 10, with 10 being the worst pain they can imagine. Ask the child, ``Where are you on this scale right now?''

You might have to do some detective work to uncover the source of the pain. A stomachache that recurs every Monday morning, for example, might be a symptom of school avoidance. You might say, ``Your tummy's sore. Is it a worry tummy? What needs to happen for the pain to go away?''

Ice is the cheapest and safest form of treatment immediately following a bruise, torn ligament, sprain or insect bite. Especially when combined with mild to moderate compression, ice reduces swelling and serves as a mild anesthetic. But do not use ice directly on the skin or on an open or bleeding wound, and don't leave it on longer than 10 minutes.

Try gel packs, ice cubes or frozen peas wrapped in a thin towel. Or keep an emergency freezer supply of colorful sponges cut into animal shapes and soaked in water.

Children in pain often try to hold their breath to keep from hurting more, but this just increases muscle tension and adds to the pain. Teach your child to exhale forcefully and then move to an easy, regular breathing pattern.

Children 1 year and older can learn to ``blow away the pain'' with a long, steady breath, as if blowing out birthday candles. Or they can literally blow bubbles, pinwheels or party blowers. Even 10-year-olds may find this appealing, since children often regress when they're in pain. You might say, ``Can you catch a bubble and blow even more bubbles from it while I wash your skin clean?''

Mental imagery helps some children manage mild to moderate persistent pain. One idea: Have them close their eyes, relax their breathing and imagine themselves traveling inside their body to examine their pain. Let them pretend to take out a magnifying glass and inspect the pain from every angle. Tell them they can spray the pain with a can of shrinking solution, then visualize it melting away and changing color.

If your child quivers at the thought of a needle or a minor surgical procedure such as wart removal, consider asking your doctor for a prescription for EMLA, an anesthetic cream that contains prilocaine and lidocaine. To be effective, it must be applied to the skin at least an hour or two in advance. EMLA numbs the skin and prevents pain from needle pricks, but doctors add that it doesn't mask the deeper sensations of vaccine entering the muscle.

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Photo: Youngsters encounter dozens of situations that can result in pain. Calm, well-prepared parents help them navigate these scary moments more easily.

Phil McCarten/Daily News