The information in this video is new. Not all healthcare providers know about it yet. So please feel free to share this information with your child’s healthcare provider, too. Reduce the Pain of Vaccination in Kids and Teens A Guide for Parents It hurts. I don’t like it. The question we get every single day, six or seven times a day, is, “Am I getting a needle today?” They start to dread coming to the doctor, and every time they have a doctor’s appointment, they’re like, “Are we getting a needle?” They’re just so anxious about it. Vaccinations are a routine part of a child’s medical care and keep children healthy. But whether vaccinated in the doctor’s office, vaccination clinic, or at school, some kids leave with the memory of pain, and this can make them afraid of doctors and
needles the next time. You know, the statistics would suggest that about 10% of people avoid immunizations
because of fear of needles. When I was a kid, it was pretty hard for me. I was just terrified. These negative experiences can lead some parents to delay or not vaccinate children. “Take a deep breath.” And if children carry these fears into adulthood, they avoid getting routine vaccinations or other medical procedures themselves. A child’s vaccination pain can be upsetting to parents, too. Parents don’t speak up about their child’s pain because they don’t know what they can do about it. If we can provide strategies for the Family Health team to use to reduce the distress that the parents and the children experience, then that is really beneficial to everybody. In this video, we’ll show parents and kids ways they can reduce pain during vaccinations. And this will make them less afraid the next time. They fit into 3 groups: What you can give, [Topical anesthetics]; what you can do, [child positioning and activity]; and how you can act, [State of mind and distraction]. Most of these cost little or no money and are easy to do. And combining the different methods together
will lead to better results. Look at this child’s response to the needle. You’ll notice that there are minimal signs of distress, pain and fear. Observe the child’s body movements, facial actions, and sounds. “Look at the bubbles! They’re stuck together, sweetie!” So let’s get started showing you how you can use these methods to reduce pain in your child during your next vaccination. “So when we go and take our needles, what does mommy say to you?” Tell your child what will happen. And be honest. Don’t tell your child it won’t hurt. It doesn’t help when they say you will feel no pain at all. That’s just a big lie. This doesn’t work to reduce pain. It promotes distrust. I think they lie to you, and when it does hurt, you’re not going to trust them later on. If your child is 4 years or older, talk to them ahead of time. This will help them to prepare how to cope. They need to know that they’re walking into a room, if they’re having a needle, and the needle’s for a good reason, it’s going to keep them healthier. Children, like adults, are less nervous when they know what’s going to happen to them ahead of time. “When I talk to you about that you’re going to have needles– how do you feel about it?” The exact timing for preparing a child depends on the individual child. Tell your child about the vaccine. “You will get a medicine to keep you healthy. The medicine is called a vaccine and it goes in your arm with a needle.” I usually just prepare them
that they probably will have to have a needle. And that it’s part of looking after their health. Tell your child how it will feel. “You may feel a pinch or some pushing for a few seconds.” It may hurt a little, but that’s okay. And it will only take a second, and then it will be over. Right? And then you’ll be fine. … Yeah. Tell them there are ways to minimize discomfort. “It bothers some kids, but others think it’s OK. We’re going to do some things so it doesn’t bother you. You can help choose what we do.” And tell them what can be done to help. “We can put on some cream to numb the skin; you can bring your favourite toy to play with, and you can sit with me.” Try to do this with enough time for a child to be able to prepare and to practice ahead of time. For a lot of children, this can be as little as one day. But not too long in advance, as children may focus too much attention on it, and become more afraid. Topical Anaesthetics. Controlling your child’s pain during vaccination
with topical anaesthetics. And another thing to stop the pain is Magic Cream. Hospitals all over the world use topical anaesthetics to reduce pain in children. They are available as a cream, gel, or patch. Most people have experience with them when they are given by injection, at the dentist’s office. At my dentist’s yesterday, when I got my needle, they actually made it numb, so I just felt like a little tap. They dull the pain where the needle enters the skin. “It’s going to take away the sting.” Your child may still have a sensation of pressure when the vaccine is being injected. This is normal. In Canada, you can buy topical aneasthetics at the drug store without a prescription. They are safe for use in children, even babies. The topical anaesthetic is applied to the upper arm where the needle will be given. “I’m going to take off the magic cream now, okay?” You need to wait for topical anaesthetics to take effect. “Is there magic cream?” “Yep, the magic cream is on you.” Maxilene takes 30 minutes to work, Ametop takes 45 minutes, and Emla takes 60 minutes. If you expect to wait at the clinic, you might want to apply them there, instead of at home. If you are using the patch, just peel off the backing and stick the patch on the skin. If you are using the cream or gel, squeeze it out of the tube in a circular pattern on the dressing that’s provided, until it’s about the size of a nickel. This is 1 gram of the anaesthetic, which is 1 dose. And then put the dressing on your child’s skin. Make sure the edges are sealed so the anaesthetic doesn’t leak out. Fold over one corner of the dressing onto itself so you have an edge to grab onto later, to make it easier to take it off. If the dressing is not available, you can use plastic wrap. Just wrap it around your child’s arm. Ask your doctor whether your child is scheduled for one or more vaccinations, so you know whether to apply the anaesthetic to one or both arms. “Looks good, eh?” Make a note of the time you applied them, or write it directly on the dressing or patch with a pen so that you can make sure you remember to take them off at the appropriate time. Remove the dressing carefully as it can get very sticky. If you remove the dressing too quickly, it can cause your child discomfort, like when pulling off a bandage. “Find that little edge and then stretch it like that.” Instead, pull the dressing out, and away from the skin slowly, while securing the opposite corner. The dressing stretches and it will lift off the skin without causing discomfort. Then just wipe the skin with a tissue. You can use a washable marker to show where the anaesthetic was, because sometimes you can’t tell after you take it off. You might notice some changes to the colour of your child’s skin, either reddening or whitening. This is temporary and goes away after a few hours. Rarely, there can be a skin rash, which could be the sign of an allergic skin reaction. If this happens, talk to your healthcare provider about using a different topical anesthetic the next time. Topical anaesthetics can be used in any setting, including schools. Talk to your child’s teacher or public health department about how to make this possible. “And when it’s ready to get the vaccine we’ll take it off. And it’ll have already penetrated through the skin. Okay?” Upright Positioning. Controlling your child’s pain during vaccination with positioning. Your child’s body position during vaccination can affect how much anxiety and pain your child feels. Children should be positioned upright before, during, and after vaccinations. You can hold younger children in different ways: in a hug or facing sideways on your lap, or seated upright on a chair or on the examination table. Pick a comfortable position for your child. Provide a hugging hold
and expose your child’s upper arm for the needle. Hold it gently, but firmly, so that your child doesn’t move it. Some younger children prefer to sit on their own. That’s okay, too. Parents can be close by to help. Avoid leaving children on their back or held down. Like adults, children can feel more nervous
when placed in these positions, and feeling more nervous can make them feel more pain. Discuss different positioning options
with your child’s healthcare provider; you can also practice ahead of time. In public settings like school vaccinations, try to provide privacy for youth, away from others that are either waiting or have already undergone vaccination. We have the whole school line up, and some girls are even screaming, she said. The nurse will just give them the shot and tell them to go. Like, that’s it, they just didn’t… I guess… care. Imagine how scared you would be having to watch this– –you’d be the next person! Keep items that will make children anxious out of sight, like needles. Like adults, when children are anxious
they can experience more pain. Rub the Skin. Controlling your child’s pain during vaccination by rubbing the skin. Rubbing your child’s skin before, during, and after vaccination, can affect how much pain your child feels. Rub or stroke your child’s arm,
starting a few seconds before the needle and continue during, and for a few seconds after, the needle. Your child will feel your touch
and this will compete with the needle, and your child will feel less pain from the needle. “I felt a little bit of poking, but not much.” The pain signals in the nerves follow the same pathway as the touch signals, so if you rub at the same time this can compete with the pain signals so that there’s less pain signals going to the brain. Use a rubbing pattern that’s comfortable for your child. “You did it! See?” State of Mind. Controlling your child’s pain during vaccinations with your state of mind. Be there. Having a parent there makes a child feel more secure, particularly younger children. “I don’t want to get the needle.” Your child looks to you for how to act and feel, so you can make it better or worse just by how you react. If you are stressed, your child will pick up on that, and that will make your child more stressed, too. I think if parents are afraid of getting shots, then the child will be afraid of shots. Yeah, and if the parents are all tense and everything, it’ll be like, “Oh my god, my parents are freaked, I guess this needle is really gunna hurt.” And they’ll be like, “No, I don’t wanna go to the doctor’s office, you’re scared, so I don’t wanna go.” Be calm, use your normal voice, and be positive. Well, I come in very cool, calm and collected, and then all of the kids, even as infants, never had any difficulty with needles. Children are less stressed when parents are positive and coach them through the pain. Children are more stressed when parents are nervous and focus attention on the pain. If you are nervous, take a few deep belly breaths to calm yourself. Simply take a slow, deep breath through your nose, for three seconds, counting to yourself: “1… 2… 3…” And breathing so that it’s your belly and not your chest that expands. And then exhale through your mouth for 3 seconds, counting, “1… 2… 3…” Belly breathing is calming for anyone in a stressful situation. It works for children, too. You can practice belly breathing with your child ahead of time. Simply rest a toy or object on their belly and ask them to make it go up and down slowly. If they are doing it correctly,
they can see the toy go up and down, as they breathe in and out slowly. Once they know how, they can do deep belly breathing without the toy on their belly. Take a few deep belly breaths yourself, and then ask your child to take a few deep belly breaths, too. You can start right before vaccination, and continue during, and after vaccination. Blowing bubbles, windmills, or pretending to blow out candles, also works to help children take deep belly breaths, and acts as a distraction, too. Distract your child. Controlling pain during vaccination with distraction. Always have some form of a toy, or something like that, to distract the kid, like a bubble machine, or a pinwheel. And let them play with it. Your child’s attention to the needle will affect how much pain your child has. Take your child’s attention away from the needle– this will reduce your child’s anxiety and pain. Distract your child before the needle, and continue during and after the needle. “And what’s that?” You can talk, use toys– “Maybe you can turn on the bubble-maker now,
how about that?” –books, and electronic devices,
like computers and smartphones. “Okay, so you just pay attention to your game.” Our dad has an iPhone that we can watch videos on. That’s the other distraction! Children can help choose a distraction ahead of time– –they are usually experts at what keeps them distracted. Cartoons! Television. Mario Kart! Gameboy. Toys! Bubble… bubble… For best results, use a distraction that involves multiple senses, sight, hearing, and touch, and have your child actively participate. The more involved your child is in the distraction, the better it will work. When they were trying to make me distracted by the bubbles, it kind of actually worked. Pick something engaging and interactive, and try to keep your child’s attention on it. “Do you like this one?” For example, have your child play a game, instead of watching you play a game. It’ll work better. “On the count of three go fast, make it fast. One, two, three, go! Well done! Ah, great.
Blow, blow, blow.” “Good job.” “Did the needle hurt a little bit?” “Did this help take some of the pain away? A lot?” The way you distract your child once may not work the next time. Be prepared to change what you’re doing. There are a few children that cope better if they watch the needle. So if your child says they want to watch, that’s okay, too. “That’s it?” “I think that’s kinda better than the first one.” Acknowledge your child’s pain but don’t focus on it. And this will help your child to stay calm. After letting them know you are there for them– “But it hurts!” “Did it hurt?” –talk about anything but the needle, or the pain. “Well, we’ll give you a kiss and then it’ll go away
–hold on, hold on, watch.” And with a normal tone of voice. “There, all done! So which one do you want to give Dr. Ed?” Avoid using words and phrases that focus attention on the pain. For example, avoid apologizing for the pain, criticizing children about how they are behaving, or reassuring or empathizing too much, as this focuses attention on the pain, which can increase your child’s distress. Let’s see what these steps look like in a younger child. “I want you to pay attention to me rubbing your arm.” Take your child’s attention away from the needle; this will lessen you child’s anxiety and pain. Help keep your child focused on the distraction. “You got it!” “You did it!” “See? Yeah! Told you, you could do it!” After you show your child you are there for them by acknowledging their pain, avoid focusing on the pain. “You’re going to pay attention to me rubbing your arm, and you’re going to blow some bubbles. Okay, can you do that? Blow the bubbles for me, I need to see you. Double bubbles! Double bubbles! Look at me!” “I did!” “You did it!” Give praise to your child after the needle. “Fantastic!” “Yay! That’s it!”
“Woo-hoo!” “You did a fantastic job.” “Does it feel better now that it’s done? Was it so bad? No, but you were scared. Did the bubbles help? I think so. You’re the best. Now it’s done.” “Now you know you can do it. You can do it for next time.” Older children are often vaccinated at school. “Yep, do your game–don’t worry about it, okay? They can bring their own distraction items such as electronic devices, smartphones, or books, to get their attention away from the procedure. “Keep breathing through your stomach.” “Is the needle in me?” Taking deep belly breaths also helps to distract children, as it keeps their attention on their breathing. “It’s gone, it’s long gone.” Final Tips for Vaccination Pain Relief. Children have a right to the most comfortable experience possible. Controlling your child’s pain during vaccination is important. Even adults, they’ll have maybe some sort of a needle phobia. Like they’re scared of it and they don’t wanna have it. They won’t even go into their doctor’s office, or stuff, and then they’ll cry, and sit there,
and have to be dragged in or something. Children can become afraid of needles in different ways: the most common is by having bad experiences
with needles in the past. “How many needles did you have?” “Two.” “Were you scared before you got the needles?” “Did you think they were gunna hurt?” But they can also become afraid
by watching others have bad experiences, or by others telling them to be afraid. “Andrew, so tell me, did it sting a lot?” Help children form a positive memory of the experience by focusing on the positive aspects of the procedure, and congratulating them on a job well done. “Tell me the stuff that made it better for you today.” “The bubbles.” “The bubbles helped? What else helped? Did sitting on your brother’s lap help?” Children will also be less anxious because they know you are helping to take away the pain. “Can you point?” Allowing children to ‘grade’ their pain during
the experience can help. I like how after we got our needle we got to evaluate how it felt. How does that make you feel if they don’t ask you about that? Makes us feel like… they don’t care. They don’t care about our pain. Nope. Gave us the needle and… goodbye. Get on out. It’s important to get people’s opinions
on how the needle felt, and how the patch felt. Now you have a toolkit. You know in your mind, there’s different things you can do. You can put on a patch, you can have a game, or a toy, an iPod, someone can be rubbing your arm. You have all these strategies that you know will help you get through the procedure so it’s less scary; when it happens again, you know what to do. These methods will make vaccinations less frightening for children the next time, because children will know that there are
ways to take away the pain. I remember what they said: “It wasn’t that bad! We got to listen to our iPods, we got to do other things”. And the next time when they had to get another shot, I found that it was much more manageable. Make a goal for your child’s next vaccination, and plan to bring any items you need, like topical anesthetics and distraction items, and practice ahead of time. Talk to your child’s healthcare provider about what you want to do. You’ll find when you ask them to partner with you, they are usually very interested. Advocating to reduce this pain and support your children will produce a child with less fear of the health system, and a happier experience at medical encounters. Knowing you have done your best to make your child comfortable will help you feel better, too. “That was a fun visit to the doctor.” These simple techniques change the experience for everyone: kids, parents, health care providers– “Oh, sorry, are we done?” “Yes.” –teachers– “Well, that wasn’t so bad.” –and public health nurses. Use the information from this video
to plan for you child’s next vaccination.

4 thoughts on “Reduce the pain of vaccination in children / Réduisez la douleur de la vaccination – Full Video”

Leave a Reply

Your email address will not be published. Required fields are marked *