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“Infants don’t feel pain as we do because their pain receptors are not fully developed yet.” Infants’ pain receptors and pathways are functional at birth. In fact, preterm and newborn infants may have increased pain sensitivity because inhibitory pain pathways are immature.

“The nurses give pain medication before she really feels the pain.” While preemptive analgesia is ideal for predictable procedures, not all pain can be prevented, and ongoing assessment is still required.

“We assess her pain using an infant pain assessment tool and give the medicine as needed.” While true, it does not highlight the proactive approach of giving pain relief before pain escalates and using multiple comfort techniques.

CRIES (Crying, Requiring increased oxygen, Inability to console, Expression, and Sleeplessness): Used for neonates (0–6 months), especially postoperative, assessing pain through five observable indicators.

FLACC (child’s face, legs, activity, cry, and consolability): Suitable for infants and young children (2 months–7 years) who cannot self-report. Scores each category 0–2 for a total of 0–10.

NPASS (Neonatal pain, agitation, and sedation scale for infants from 3 to 6 months) This is validated for preterm and term neonates up to 100 days old. It evaluates both pain/agitation and sedation levels.

“I understand that preemptive analgesia is giving Nathan pain medication before he has pain and could be given before surgery.” This reflects the definition and timing of preemptive analgesia.

“Giving this medicine early may help prevent complications after surgery.” Effective early pain control can reduce complications such as shallow breathing, immobility, or delayed healing caused by uncontrolled pain.

“By controlling Nathan’s pain, he will be more comfortable and may be able to go home sooner.” Improved comfort can facilitate earlier mobilization and discharge.

Telling a child that "big children are quiet" is shaming and dismissive. It implies that the child did something wrong by crying, which is a normal emotional reaction at this age.

Explaining why vaccines are given may be more appropriate before the procedure, but afterward, the child is likely focused on the pain or distress, not the rationale. At 5 years old, the child may not fully comprehend the explanation either.

Informing the child that the provider ordered the vaccine may seem like an attempt to deflect responsibility and does nothing to comfort or validate the child's feelings.

An infant cannot self-report pain. Behavioral and physiologic assessment tools like FLACC or CRIES are more appropriate.

While some 3-year-olds can use the scale, many may not yet have the cognitive maturity to understand and accurately use it. The scale is more reliable in slightly older children.

A preverbal child with cognitive impairment cannot self-report; observational tools like FLACC or the Non-Communicating Children’s Pain Checklist are better suited.