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Thursday, November 3, 2011

Helping Kids Handle Needle-Phobia

By Roy Benaroch, MD

Immunizations have a been a hugely successful part of public health, leading to drastically reduced rates of serious infections. Doctors and parents are big supporters.

The kids? Not so much. Those needles, we have to admit, can be scary. Though there’s no way to take 100% of the sting out of vaccines, there are some things parents and health providers can do that ought to help reduce the tears.

The parent’s own reaction can be a powerful influence on how children perceive shots. Excessive parental reassurance, apologies, or criticism makes the immunizations more painful. So keep in mind these important things not to say:

  • “This isn’t going to hurt.”
  • “I’m sorry you have to go through this.”
  • “Act more like a man! You’re the only boy who cries for shots!”

On the other hand, parents who remain calm and matter-of-fact, or are able to distract their child, can help make the experience better. Among the best distraction techniques are story-telling, reading, blowing bubbles or pinwheels, or deep breathing. Often, anxiety about shots is much worse than the actual pain of the shots! A little distraction and a trip for ice cream afterwards works better than a whole lot of talking, reassurance, and discussion.

For younger babies, giving vaccines along with a little sugar-water seems to help. It can also be helpful for some babies to nurse during or immediately after vaccines — though moms need to help hold, tight, during the actual procedure.

Some topical anesthetics can reduce the pain of injections, though none works perfectly. Ela-MAX is available over-the-counter. It has to be applied at least 30 minutes before the immunization to be effective.

If you’re interested in using a medical anesthetic such as  Ela-MAX or another product, please check with your pediatrician beforehand to ensure that you’re using it correctly and putting it in the right place. Some doctors like to use a quick squirt of a cooling agent on the skin right before injections. It might not actually dull the pain, but at least serves as a quick distraction.

Immunization technique is important. If more than one immunization is needed, they should ideally be given in groups together rather than one-at-a-time. With combination vaccines, multiple “shots” are given at the same time though the same needle. I’m sure children appreciate fewer sticks! However, not all vaccines are available in combos.

One vaccine is available without a needle: the influenza vaccine brand FluMist, which is squirted up the nose. It’s safe and effective for most kids aged 2 and older.

It would be great if we had a completely pain-free way of giving vaccines, but at least for now we’re stuck with the needle. Fortunately, the actual pain is quite brief and manageable. The diseases themselves are far worse!

Posted by: Roy Benaroch, MD, FAAP at 10:43 am

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