Most children and adults have some dislike of needles, but for some, the fear is so intense that it interferes with their well-being and health. This fear of needles, which often develops around age 4-5 years old, is real, affecting as many as 63% of all children. Some (up to 5%) have a genetic predisposition to becoming light-headed or even fainting.

Many children will carry this fear into adulthood, potentially leading to avoidance of doctors altogether. As pediatricians and as parents, we understand your child’s feelings. You never want to see your child scared or in pain, and we realize we put both you and your child in an uncomfortable situation.

Based on the Center of Disease Control’s recommendations, however, we administer sometimes up to four shots in a visit to help protect your child from many serious illnesses, and more than 20 shots by the age of six. By their teenage years, most children have had close to 30 vaccine injections. Beyond vaccines, your child may need to have blood work done or an intravenous (IV) line placed in the emergency room or in the hospital. Yikes!

All of these procedures can cause tremendous anxiety for both the parents and the child. To help ease these fears, I would like to offer some coping strategies:

• Educate your child about shots. Most fears come from misconceptions - that the shot will take a long time, or that the needle is very big. This often is not the case. Videos can help as a form of habituation, or repeated exposure, to help decrease anxiety around receiving injections. Also, having brave role models can help. A great video for younger children is Jim Henson’s Sid the Science Kid: Getting a Shot, You Can Do It!
• Here are some links for shorter videos of children receiving injections:
• Kindergarten: brave patient number 1
• Older children: Teen receiving allergy shots
• Be honest with your child, and ask the medical staff to be honest as well. The shot may hurt a little, so we should not say that it won’t. But we should emphasize that the injection will be very quick, that the doctors and nurses will help make it as comfortable as possible, and that your child needs it to stay healthy.
• Distraction techniques can help. Have your child take a big breath in or out during the injection. Blow bubbles, blow on a pinwheel, play music, or read a story or play a short video - all of these things will draw attention away from the actual shot.
• For older children and teens, have your child practice being brave. Karen Dahlsgaard, a psychologist at Children’s Hospital of Philadelphia, has introduced the idea of “Brave Body.” By acting brave, your child can feel brave; she should sit up tall, shoulders back, arms relaxed. Your child can also bring a “coping card,” which is a card with a brave saying that the patient can read before and during the injection.
• An example of an actual coping card saying is, “It will hurt for a second, but then it will be over. Millions of people have gotten shots before me and this is no different. I can do it.”
• Reward your child for being brave and for facing his fear. A small reward, in the form of a small treat or activity, can help turn the experience into a positive one and hopefully make the next visit a bit easier.



I hope some of these ideas will be helpful next time your child faces an injection. If you have any questions, or desire more information, please feel free to contact me or contact your health care provider here at PAGS.

Also, feel free to share your experiences with your child in the comments section below – we’ve had children try to escape, and others who have hidden under the exam table. It’s always comforting to know that you’re not in this alone!