Sick and injured children are still not receiving adequate pain relief, the government's children's tsar warns today.

Al Aynsley-Green, a consultant paediatrician and England's first children's commissioner, is urging greater efforts to ensure all children who need it receive help with pain, whether through "magic cream" - anaesthetic gel - to ease the hurt of injections, rapid access to painkillers in accident and emergency departments or support for severely disabled or very ill children receiving palliative care.

While the UK has made great strides in managing children's pain over the past 30 years - prior to which it was widely believed that babies and infants did not feel pain as adults do - methods of alleviating it are not applied consistently, too few drugs are licensed for children and parents are too often left out of pain management decisions, the commissioner said. "Pain should be at the centre of everybody's thinking about managing a very sick child," he said.

Prof Aynsley-Green's call, made today on a global "day against pain" held annually by the International Association for the Study of Pain and this year focusing on children, is echoed by other medics.

Professor Linda Franck, co-director of the Well Child Pain Research Centre at Great Ormond Street children's hospital in London, said research into children's pain remained "just minuscule compared with the amount of research funding and support for other aspects of medical care.

"We still have so much more to learn both in terms of how to measure the extent of children's pain and what to do about it."

Prof Aynsley-Green, whose own pioneering research on stress levels in sick babies in the 1970s proved that infants feel pain, pointed to A&E as an "adult-centric" environment which did not always understand pain in children. "Their [children's] manifestations of pain may be different from adults', for example they may lie perfectly still." There was a need for better training of those treating children in pain, particularly those who were too young to explain their experience or were unable to do so through disability, he said.