During the procedure

  • Be there if you can

It is very helpful for a child to have a parent with them whilst a painful procedure is being carried out. If, for any reason, you are unable to be present, that is OK. Is there another adult who your child is comfortable with who can be there, if you can’t?

  • Try to appear calm and confident

Try to appear calm and confident and be ‘matter-of-fact’ about the procedure. If you are worried about it, ask the burns team for help because your anxiety might ‘rub off’ on your child.

  • Give some control over the treatment to your child

This can help to reduce their experience of pain. For example, let your child decide whether to sit on a chair, in a bed, or on your lap for their treatment. Give them a job to do, for example, “your job is to hold your arm still”. They can also choose which coping strategies they are going to use. Make sure this is discussed with the burns team first to ensure that they are real choices that can be followed through.

  • Use distraction to help reduce pain and anxiety

Distraction involves helping your child to focus on things other than the procedure. For example, blowing bubbles, looking at picture books, watching a DVD, playing a game or with a favourite toy, using ‘apps’ on iPads to play games or watch videos, singing familiar or silly songs, engaging them in conversation, or listening to music.

  • Try relaxation strategies

Relaxation strategies can also be very helpful but it is important that they are practiced beforehand. Try slow breathing techniques (young children can be taught to breathe deeply and blow the pain away using bubbles), guided imagery (relaxation and imagination), muscle relaxation techniques, or listening to music (if your child needs to be still, keep the music relaxed and slow).

  • Teach self-talk

From 6 years of age, children can be supported to say calming and relaxing things to themselves during a procedure. From about age 10, children can learn to do this by themselves. Examples of useful self-talk include: “It will be over soon”, “I can handle this”, “I’m doing well”, “It’s not nice now but it will help me in the long run”.

  • Give positive feedback and praise

Children respond well to praise. Praise any attempts to cooperate or use helpful coping strategies, such as “you are doing great slow deep breathing” or “you kept your arm really still”.

  • Let your child know that it is ok to feel upset

Painful procedures are difficult, and a child who is trying to cooperate should have as much praise as a child who is able to cope well. Because of what they have been through, or perhaps because you think you were not able to protect them from harm, you might want to spoil your child to compensate them. Children should be praised for doing their best but try to avoid bargaining with your child to compensate them for upset with big rewards.