Helping babies and kids cope with needles
By Ann Chandler
on October 25, 2012
Canadian immunization guidelines recommend
that a child should receive more than 20 needles
before the age of 18. Those early immunization
experiences can make a child anxious about
receiving future needles, but you can help your
child through the process.
Research from the Centre for Pediatric
Pain Research in Halifax shows that telling
a child not to worry can actually have the
opposite effect – and increase anxiety. “Parental
reassurance makes kids feel worse and have
more pain during needles,” says Dr. Christine
Chambers, professor of Pediatrics and
Psychology at Dalhousie University. “We’re not
really sure why, but there is some evidence that
it serves as a signal to children that their parents
are feeling anxious.”
If, like 10 percent of the adult population,
you have your own fear of needles, a little deep
breathing could help. “It is critically important
that parents manage their own anxiety when
they take their child for needles,” says Dr.
Chambers, who is also a Canada Research Chair
in Pain and Child Health.
Establishing these practices from day one can
make needles easier as your child grows. Dr.
Chambers encourages using topical anaesthetic
creams, such as EMLA, Ametop or Maxilene.
“They have been shown to significantly reduce
pain. Many parents are surprised to learn that
these creams are so readily available,” she says.
They can be purchased over the counter and
should be applied to the skin approximately
an hour before the procedure. Consult the
pharmacist to ensure proper application, says
Physical body positioning is also important.
Dr. Chambers and her colleagues recommend
cradling and breastfeeding and/or feeding sugar
water (one packet of sugar with two teaspoons
of water) for infants undergoing painful
procedures. “Not only are these comforting to
the child, they are actually analgesic (which
means they reduce pain).”
Pay attention to what you say after the
procedure, too. “Our research has shown
that what children remember about a painful
procedure (vs. what actually happened) is a very
powerful predictor of how much pain children
will experience at a subsequent procedure. Take
a moment after the procedure to praise your
child for a job well done and remind them how
well they coped. It might influence how well
they cope next time,” says Dr. Chambers.
Tips for helping older kids deal with needles
The following guidelines have been
adapted from Toronto Public Health to
help your child develop strong
coping skills for future procedures
and prevent them from developing a
fear of needles:
- Talk to your child about the vaccination.
Explain what immunization
is and how it can help to keep them
- Explain that the medicine will be
put into their arm. Don’t tell them that
it won’t hurt. Say that the pain lasts a
short time and feels like a “sting” or
- Prepare school-age children in
advance. Tell toddlers and preschoolers
just before the procedure.
- Encourage your child to bring
several items along that will interest
them or provide comfort: a favourite
book, electronic game, stuffed toy or
- For added comfort, over-the-counter
medications can be used to
numb the area.
- Stay calm. Your child will be able
to sense your fears or worries, which
will intensify his own. Involve your
child when speaking to the doctor or
nurse by having them share a recent
accomplishment, fun activity or
- Have your child sit upright when
receiving a needle. Tell them to take
a few deep breaths. This will reduce
their pain and stress. Have them
blow on objects like pinwheels, party
blowers or bubble wands just as the
needle is given – it will help take their
mind (and their eyes) off the needle.
Sing a favourite song or read a favourite
- Positive reinforcement will make
children feel confident about the coping
skills they have learned and will
make them feel better prepared for
their next immunization.
- Acetaminophen or ibuprofen can
be used afterwards to ease fever, irritability
or soreness. However, experts
don’t recommend giving these medications
prior to the immunization.
More information for helping children
cope with pain is available from the
Centre for Pediatric Pain Research
at IWK Health Centre in Halifax.
Originally published in ParentsCanada magazine, November 2012.
By Ann Chandler|
October 25, 2012