Today in the chart

Most pediatric nurses and PAs probably already have a huge bag of tricks for helping kids deal with the pain or fear of shots. Here are some tips to help kids feel more comfortable and prepared.

Help Parents and Caregivers Prepare

Even before the appointment, give parents tips on preparing their child for the vaccination. The Centers for Disease Control and Prevention has a helpful page of suggestions for ways parents can make vaccinations less traumatic and frightening for kids. Some tips are aimed at babies or very young children, such as recommending breastfeeding during the shot, but others apply to kids of all ages.

Offer Choices

Ask kids if they prefer to watch or look away if they want to hold a hand, squeeze a ball, look at a picture, or watch a video on an iPad. Letting them make choices helps them feel more in control, which is less scary. Having a sense of agency means they’re not just victims of their circumstances; they can play a role in how the experience goes.  

Don’t Lie

It’s important that kids know exactly what to expect, so don’t tell them they won’t feel anything if they’ll feel a prick of pain, or they’ll trust you—and other healthcare professionals—less later. You don’t want to exaggerate the pain, but kids should know there will be a brief moment of pain that quickly goes away so they can prepare themselves mentally for it.

Validate Their Feelings

It’s natural for people to feel anxious or nervous about needles. Dismissing or minimizing that anxiety will make kids think you don’t care or take their feelings seriously. Avoid telling them not to cry or claiming it’s no big deal. To some kids, getting an injection is a Very Big Deal, no matter what you say, and claiming otherwise will reduce their trust in you and possibly other healthcare professionals.

Use a Numbing Agent

Cold sprays, lidocaine creams, or even hemorrhoid cream can lessen the pain by first numbing the area.

Consider Using a Pain-Minimizing Device

Buzzy Bee is a vibrating bee or ladybug that can be worn on the arm just above the injection site, with or without a cold pack. The vibration can act like a numbing agent or distract the brain, so the shot hurts less. Another is ShotBlocker, an arch-shaped piece of plastic with prickly bumps on one side. When pressed to the skin during an injection, the brain again can’t easily distinguish one sensation from another, distracting the child from the pain.

Use Visual Distractions

For kids with needle phobia, it’s often the anticipation, not the shot itself, that causes them the most anguish. Distracting them with a TV, a video on a smartphone or tablet, or some other captivating device can keep their mind off the shot until it’s over.

Have Tactile Toys on Hand

The ability to squeeze a stress ball or hold a soft stuffed animal can put kids at ease, distract them, give them a release for stress or pain, or stimulate endorphins in the same way that petting animals does.

Model Calmness

Kids pick up on adults’ feelings far more than we realize, so they’ll be even more nervous if you’re anxious. A warm smile, a joke, a warm touch, direct eye contact—all of these gestures can make a difference in helping a child feel more at ease.

Offer Praise Afterward

Especially for kids who are scared of needles, a word of positive feedback later can help them feel better about the experience. Tell them how brave they were, that they did it, that you’re impressed—whatever feels appropriate to let them know you’re proud of them. Doing so also models this behavior for parents or caregivers, who will hopefully join in.  

Have Bubbles Available

Children who are anxious may breathe quickly and shallowly, which only enhances their anxiety and can turn into a negative spiral. Deep, slow breaths go a long way to bring down anxiety and stress levels, and sometimes even blood pressure. One way to help kids learn to take those deep, long, slow breaths is to blow bubbles. You can’t blow bubbles with rapid breaths but you can if you slow down and take your time. Mini bubble containers, like those used at weddings or as party favors, can be cheaply bought in bulk and stored out of sight to be used for those kids who appear to be struggling the most.

Use Proper Technique

Aside from all the tips to reduce kids’ anxiety and pain, it’s important that you, as the healthcare professional, ensure that you’re giving the injection in the correct location and with the proper technique. Allow the alcohol to dry before the injection, keep your thumb/finger off the plunger until ready to give it, insert and remove the needle quickly, and immediately apply pressure afterward. For more specific details on these tips, check out this article from Women’s Healthcare.