Fear of needles is extremely common in children — and in adults. At Spring Valley Pediatrics, we use evidence-based techniques to reduce pain and anxiety during immunizations. The most effective strategies include distraction, comfort positioning (sitting on a parent’s lap rather than lying down for older children), and topical numbing cream applied before the visit. Vaccines do not need to be traumatic experiences.
As parents we all know that immunizations, although necessary, can be a source of anxiety for little ones (and for us!). Here are Dr. Jessica Long‘s tips on how to keep our children calm during immunization visits.
I always hoped that, since I’m a pediatrician, my children would have no qualms about anything that happens at the doctor’s office. I was wrong. My children get as upset about shots, as fearful of a blood draw, and as manic about opening their mouths for a strep swab as the next kid. But shots don’t have to be a horrible experience for kids and parents alike. There are simple things we can do to calm our child, no matter her age, to make everything go a bit smoother.
Leading up to the doctor’s visit, your toddler or school-aged child may ask if it will hurt. Honesty is the best policy. Let him know that yes, it will hurt for a second, but it won’t be bad and you’re right there with him. Some kids like to role play beforehand, pretending to be the doctor giving shots to their parent or stuffed animal, which can make them more confident for the real thing.
At the doctor’s office, the first step in calming your child is checking in on your own mood. If you are relaxed that will rub off on your little one; if you’re stressed, that will too. How would you feel about getting a shot yourself? Probably not exactly excited about it, but also not too worried or afraid. You should feel that way about your child getting a shot. And your child will notice how you feel, and will tend to feel that way herself. Children are perceptive – pretending won’t help.
At the time of the shot, distraction can be very helpful. An infant may want to nurse, suck on a pacifier, or be skin to skin on a parent, all of which have been shown to reduce the stress of painful procedures in babies. An older child may want to hugged or cuddled, read a book, or even watch a favorite video on your phone. Encouraging your child to cough loudly right before and right after the shot has also been shown to reduce painful reactions in school aged kids and even middle schoolers (yes, they get scared, too).
Congratulate your child on being cooperative and brave, but don’t make too big a deal out of it Give her a high five, a hug or a cuddle to let her know you’re proud of her and then head out for a small reward. In our house we go for cake pops, and knowing there is a special treat waiting for my girls (and me!) at the end of a tough doctor’s visit puts everyone a little more at ease.
Frequently Asked Questions
How can I prepare my child for vaccines before the appointment?
For young children (under 3), minimal preparation is best — too much advance notice increases anticipatory anxiety. For older children, brief honest preparation (“You’ll get a shot today that helps keep you healthy. It will hurt for a second and then it will be over.”) is better than avoidance or deception. Practice deep breathing or blowing bubbles as a coping strategy.
What is the most effective distraction technique during shots?
Evidence-based distraction techniques include: blowing (blowing bubbles, blowing out a deep breath, or blowing pinwheels — this activates the exhale reflex and reduces pain perception); watching a video on a phone or tablet; focusing attention on a specific object in the room; and counting or singing. Distraction works best when started just before the injection.
What is comfort positioning and does it help?
Comfort positioning means the child sits upright on a parent’s lap or sits beside the parent, rather than lying flat on the exam table. For infants, holding them skin-to-skin or breastfeeding during the injection reduces pain significantly. For toddlers and older children, sitting rather than lying reduces anxiety and perceived pain. We actively encourage comfort positioning at Spring Valley Pediatrics.
Can I get numbing cream for my child before vaccines?
Yes — topical numbing creams like EMLA or LMX can significantly reduce the pain of injections. They need to be applied 30–60 minutes before the injection, so they must be applied at home before the appointment. Ask your Spring Valley Pediatrics physician for a prescription or recommendation at the visit before vaccines are due.
What should I do if my child is extremely needle-phobic?
Talk with your Spring Valley Pediatrics physician. We can discuss a plan that may include numbing cream, distraction techniques, scheduling strategies (what order to do things in), and — for very anxious older children or teenagers — a referral to a psychologist familiar with needle phobia. Needle phobia in teenagers can lead to avoiding important medical care, so it is worth addressing proactively.
