Children's Health: Helping Kids With Needlephobia
It's no secret that children don't like shots. As the needle nears a bare arm, they scream and squirm. Nonetheless, the current vaccine recommendations from the Centers for Disease Control and Prevention call for no fewer than 27 shots by age 6. And that's just the routine stuff like measles and mumps shots. Medical treatment for kids can also mean drawing blood, injecting antibiotics, and taking bone marrow samples from cancer patients.
To avoid the misery needles bring, try getting the child to blow soap bubbles. That and other distractions work better than simply murmuring comforting words, according to a new review of psychological methods for minimizing pain from needle sticks. The evaluation is in today's issue of the Cochrane Review, which is published by the Cochrane Collaborationwww.cochrane.org, a widely respected international nonprofit group that evaluates health treatments.
The Cochrane researchers found that techniques like suggestions and coaching ("Don't worry. It's not going to hurt that much") were not effective at reducing the feelings of pain. Neither did asking kids to blow out a breath when the needle went in.
What did work was a diversion. Focusing on another activity got the youngster's mind off the needle and the sensations tied to it. This makes sense to Barbara Frankowski, a pediatrician at Vermont Children's Hospital in Burlington who was not involved in the review. "In my office we use a lot of bubbles," she says. "Or we get them to blow on a pinwheel." The Cochrane group also found that getting kids to watch a video or play a video game got their attention away from the sharp jab. For older children, Frankowski says, just talking to them about some other topic tends to divert their attention.
Another effective approach, the Cochrane researchers found, was hypnosis. It reduced kids' self-reports of pain. A medical hypnotist can train a child to relax, often by counting slowly and breathing slowly, and enter an altered mental state. The hypnotist then often suggests that the child focus on a happy memory, or that pain is distant and far away.
Effective though hypnosis may be, it's not for the routine chickenpox or measles shot. It usually requires a few sessions to train the child. "I think it would only work well with a child who has a disease that requires ongoing shots, like a cancer patient getting some kinds of chemotherapy or a bone marrow tap," Frankowski says. "For other things it requires too much time." And indeed, most of the studies showing that hypnosis worked were done on kids with cancer.
Frankowski adds one thing to the list of stuff that doesn't work. "If parents tell their kids for a week in advance that they are going to get a shot, it builds up a lot of anxiety," she says. It doesn't prepare them for the pain and just makes things worse. What to do in that case? Not much. "The child is usually very unhappy. And we ask the parents not to do that ever again."
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