On the first day home, parents reported that 86 percent of their children were experiencing "significant overall pain." Despite that, one in four children received minimal pain medication: zero or one medication dose that day.
Three days after surgery, two-thirds of the children still had significant pain, with 41 percent getting minimal medication, according to the study.
The study authors speculated that under-medication could be due to parents' fears that their child will become addicted to medications such as Tylenol with codeine. Parents might also not realize how much pain their children are in, especially if the child is too young to communicate verbally.
"There's a lot of nervousness on using pain medications," Goldschneider said.
The study also found that parents with less education and with children who were "more reactive" were less likely to give pain medications, while parents with impulsive children were more likely to follow dosing instructions.
Children may also just have trouble swallowing the pills, raising the issue of whether other "delivery systems," such as a patch, might be more useful, Cantwell said.
"We need to educate parents on how to use these medications," Goldschneider said.
A second study in the same issue of the journal found a 70 percent jump in venous thromboembolisms (VTEs) -- blood clots that usually occur in the veins of the legs -- diagnosed at children's hospitals between 2001 and 2007.
In 2007, 58 cases of VTE per 10,000 hospital admissions were recorded, versus 34 per 10,000 in 2001. Almost two-thirds of the children had underlying medical conditions, most commonly cancer, the study found.
The authors, from the University of Pennsylvania and the Children's Hospital of Philadelphia, could not say if the increase was the result of more actual cases or better detection.
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