In our family, ’tis the season for flu shots; in every family, shots happen — at nearly every trip to the doctor until age 4, and at intervals thereafter. Rare is the child who looks forward to the appearance of the needle, but there are things parents can do to make the experience of getting a shot easier, and reduce a child’s anxiety before the fact, and in anticipation of the next shot.
Amy Baxter, a pediatric emergency physician, pain researcher and the inventor of Buzzy, a reusable, natural personal pain relief device, has dedicated the second half of her career to preventing and relieving needle fear in children. “For most kids, needle fear comes from a traumatic experience between ages 4 and 6,” she says. Some children develop anxiety around shots even earlier. “Children who fear needles grow up to be adults who don’t get flu shots or update their own vaccinations, are less likely to donate blood, and in really severe cases, refuse insulin or delay diagnosis because they’re afraid to go for regular checkups.”
Dr. Baxter suggested 12 things parents can do to help prevent a child from developing a fear of needles, or help a child who is already fearful.
1. Don’t threaten. “You’d be surprised how many parents come to the doctor’s office and say to their child, ‘if you’re not good, you’re going to get a shot!’”
2. Don’t lie. Don’t tell your child “it won’t hurt,” or assure her that you “love getting shots” or lie about whether a shot is in the offing before or during a pediatric visit.
3. Do be warm, but matter-of-fact. Listen to the concerns of your child, but don’t leave the door open for any possibility of not getting a shot. Say, “I know you’re afraid, but we can make this easier.”
4. Do make a plan if your child is already anxious. Talk with your child about what you’re going to do if she needs an injection. Consider topical anesthetic or bringing distraction materials. Practice taking deep breaths.
5. Do use distractions. Counting and visual activities are the most effective. Look for phone or tablet games where children need to move or find things. Count ceiling tiles, or how many letters there are in a sentence.
6. Do offer sweets. For infants and younger children in particular, nursing or drinking cold apple juice right when they get the shot stimulates oral distraction. Older children can have something they don’t usually have as a treat during the injection.
7. Do try a topical anesthetic. Apply, then put Glad Press ‘n Seal over the medication — it really sticks to skin.
You can also give ibuprofen an hour before the visit.
8. Do sit up. When young children are sitting on a parent’s lap, they show less distress over a shot than when they’re held down and lying flat. A good position for an anxious child is straddling a parent’s lap in a hug.
9. Do space out shots if that makes sense for your child. The more successful shots, the less afraid they’ll be later. For some children it makes sense to do shots one at a time.
10. Do invite your child’s participation. Did the topical anesthetic or the distraction help? What could you do next time?
11. Do ask about shot order. For young children, distress is less if they get the least painful shot first. For adolescents, the more painful shot should come first.
12. Finally, do speak up. Advocate for your children, Dr. Baxter says. Ask for time to help your child, ask to hold or nurse your child. Many pediatric offices just want to get the shots done as fast as possible, but it’s important that children have a positive experience now, so that they’re more likely to have a good health care experience for the rest of their lives.