No one likes injections. In just the first year of a healthy baby’s life, 12 shots will be administered. More injections will follow through adolescence, making needles an uncomfortable but necessary fact of life. Micah Resnick, MD, a board certified pediatrician at Mount Sinai Doctors Queens, explains how to minimize the stress and pain surrounding these injections, which help you and your child stay healthy.
Only a handful of my friends get their annual flu vaccines, the rest skip out because of their needle phobia, so it is no surprise that infants and children are fearful of injections and blood draws. How can we, as parents and as physicians, help alleviate the fear? I never lie to parents when they ask me if infants can feel pain. Yes, they can. However, for babies and children of all ages, it is important that parents stay calm, smile, and use encouraging words. Your child, especially toddlers and older children, will take cues from you.
For babies, physical contact is very important. Hold your baby close in an upright position. You may want to breastfeed before, during, and after the immunization to calm your baby down. There are over-the-counter topical anesthetic creams that may minimize the pain, but these can take 30 to 60 minutes from application to start working.
Toddlers require more active intervention. Tell your toddler about the injection ahead of time. You know your child best—some young children respond well to being told just before, while other children may do better with several short discussions in the days leading up to the doctor visit. In either case, try to distract your child at the time of the injection by blowing on a pinwheel or even blowing something imaginary out of your hand. Don’t tell them it will only hurt a little, or it will be over soon. This will only remind them of the discomfort.
School-aged children are typically more reasonable. Honesty is the best policy here. The goal is to set a realistic expectation. Explain to your child that injections are necessary. Let them know that the little pinch from the needle keeps them from getting sick. For the injection, your best bet is to distract your child: you can play music or talk about a book you both like. In my office, I have colorful posters of animals and trees on the wall. I often point to those animals or ask a child to list the different ones on the wall he or she recognizes.
Talk with your child about the experience afterward. Acknowledge the pain. Give praise for doing a good job, or even just for a “best effort.” Ice cream or another enjoyable treat may also be in order.
What do you do with an absolutely inconsolable toddler or child? Number one, don’t drag it out. Take a short time to reason with your child, and if it is a no go, hold your child while the injection is given. It is only very rare cases, when the fear turns into a phobia, that the services of a psychologist may be necessary. Remember, we are hoping that your child sees injections as an unpleasant fact of life. Stay positive, stay supportive.
Micah Resnick, MD, is a board-certified pediatrician at Mount Sinai Queens and an Assistant Professor of Pediatrics at the Icahn School of Medicine at Mount Sinai. His clinical interests include well-child care, adolescent health, preventive medicine, and patient and family education. By educating patients and their families, he empowers them to make healthy decisions and strengthens their compliance with clinical recommendations.
Quick Tips for Parents
- Use contact as a comfort. Hold your child using as much skin-to-skin contact as possible.
- Provide a distraction. Use movement, sucking, music, toys, talking, rocking, or singing to distract your baby.
- Breastfeed before, during, and after an injection. Nursing may be the perfect pain reliever for simple procedures. It involves holding, skin-to-skin contact, sucking, and a sweet taste—all proven ways to reduce the pain a baby feels.
- Give a sweet treat. As an alternative to breastfeeding, give your child a sugar solution on a pacifier. Remember, never use honey in babies under one year old as it can cause botulism.
- Have a pain reliever handy. Ask your pediatrician about proper dosing of pain relievers—acetaminophen or ibuprofen—for your baby, or inquire about other medicines to help relieve pain after the visit.