No kid likes getting a shot, and for many children, the fear and pain surrounding immunizations can make them dread every doctor visit. But doctors can make children's shots less of an ordeal, and parents can borrow from their playbook to reduce the misery of shots.
A new study in Pediatrics detailing how doctors can make shots less miserable couldn't have come at a better time. My usually cheery second-grader fretted over whether she'd need a shot at the doctor's this morning, and was upset when she was told she would. I'd come armed with lollypops, since I'd read up on research saying that a bit of sugar just before the shot reduces pain, even in tiny babies. And I also had "The Brave Monkey Pirate," by Hayes Roberts, loaded on my iPhone for just this occasion. The story explains how Modi overcomes his fear of shots, with the help of his dad, a crab wizard, and a rock that transports him into the future. My daughter read it while waiting for the dreaded shot.
The pediatrician helped, too, offering to spritz her arm with a cooling spray that temporarily numbs skin. That, and numbing lotions like lidocaine, can help reduce the initial "ouch." My daughter did wince, but the shot was over before she had a chance to get upset. Then we were off to the corner store for a congratulatory bag of Cheetos.
It turned out that our pediatrician's office did a lot of things right, according to the Pediatrics study, which tested whether training parents and office staff in techniques to reduce children's pain and anxiety made immunizations less stressful. The techniques included:
- Preparing the child and family for shots by giving them information on ways to reduce anxiety and pain.
- Giving a baby a pacifier dipped in sugar water just before the shot. (Lollypops work great for older kids.)
- Distracting older children by having them count, breathe deeply, or blow on a pinwheel during the shot. (Modi, the Brave Monkey Pirate, squeezes his magic rock and counts to three.)
- Making sure the person administering the shot uses good technique, including using a longer needle to keep the injection away from sensitive nerves in the skin. The study also tested ShotBlocker, a flexible piece of plastic used to put pressure on the child's skin around the injection site, which is marketed as reducing pain.
- Using topical anesthetics like lidocaine to numb the skin.
The parents in the study, which was led by researchers at Children's Hospital Boston, said they learned new comforting and pain reduction techniques, particularly the sugar-dipped pacifier for infants, and pinwheels or ShotBlockers for older children. Pediatricians reported increasing the use of longer needles, which reduce pain by delivering the immunization farther away from the skin, and also increasing their use of sugared pacifiers, pinwheels, focused breathing, and ShotBlockers.
Much of medicine focuses on life-or-death issues, like preventing and treating major diseases. But for most of us, our experience with medicine is far more mundane. For children, the biggest question about their health may well be: "Do I have to get a shot?" This study shows that grownups can do better at making children's encounters with medical care much sweeter.