Nurses have developed guidelines for dealing more effectively with childhood pain after asking children for their first-hand experiences.

The guidelines, commissioned by the Royal College of Nursing and the charity Action for Sick Children, were launched at the International Council of Nurses Centennial Conference in London on Monday.

They stress that pain can be recognised in even very young babies and that it is important that children are asked how they feel rather than assumptions being made that medical staff know best.

The guidance is partially based on interviews with 162 children aged two to 18 who underwent medical care.

They were asked about their own experience, what aspects of their care they viewed as positive, and what they would liked to have happened when they were in pain.

Young people in hospital often face distressing and painful procedures such as biopsies, lumbar punctures and the taking of blood and bone marrow samples.

Most children and young people describe the anxiety they feel before these procedures as the most distressing aspect of their illness.

'Nothing more upsetting'

RCN paediatric adviser Sue Barr said: "There is nothing more upsetting than seeing a child in pain who can't describe what they are feeling.

"These recommendations will mean we can recognise their pain more quickly, make it much easier to judge how bad the pain is, and then treat it effectively."

The guidance makes nine key recommendations including:

• Nursing staff should be vigilant and assess pain regularly, in particular watching for unexpected pain
• Children's appearance, activity and facial expression are a good indication of pain levels
• Children react to pain in different ways
• Young children should be given adequate opportunity to talk about their pain
• Older children should be given the opportunity to assess their own pain using methods such as graphs, or selecting appropriate descriptions from a list of words
• Parents' opinion should be sought, but should not override what the children themselves say

The guidelines will be widely disseminated to paediatric nurses, who will be encouraged to spread their message to doctors.

Their impact will be assessed in two years' time.