As parents, when our kids get their vaccination shots, it’s easy to brush off their fears. “It’ll just be a little poke,” we’ll say. Or, if they’ve reacted badly to previous shots, we might even put off or avoid vaccinations altogether. The truth is, shots can really hurt—both the initial jab and the compounds in the vaccine. Rather than skirting the issue, it’s better to address the fear—and the pain—head on. The good news is, there’s lots of research-based ways that you can make shots hurt less for your kids. Earlier this week, the Canadian Medical Association Journal (CMAJ) published updated guidelines on what to do and what to avoid when your child is due for her shots.
Do head to the pharmacy in advance to pick up a topical anaesthetic cream or patch. “Parents can buy this over the counter,” says Dr. Christine Chambers, a clinical psychologist at the Centre for Pediatric Pain Research in Halifax. You’ll need to know where the needle is going on the body (call your doctor’s office to find out), and it needs to be applied to the skin 30 to 60 minutes ahead of time. Dr. Chambers recommends asking the pharmacist to help show you where and how to put it on.
Do breastfeed your baby before or during the shot and hold very young infants skin to skin.
Do hold your kids, particularly if they’re under three, rather than have them lie flat. For older kids, have them sit up in a chair or on the examination table. You can help hold your older child’s limb steady, but don’t forcibly restrain your child as this will increase fear.
Don’t avoid talking to your child about the shot, and don’t sugar-coat it. Luckily, if you use a topical anaesthetic and a distraction tool, the pain shouldn’t be too bad.
Do use distraction tools, such as tablets, phones and books, or have your child look out a window or count dots on the wallpaper.
Do use age-appropriate language to describe what will happen and why the shot is important. “Sometimes we forget to let kids know why they need shots,” says Dr. Chambers.
Don’t give your child an oral pain reliever, such as acetaminophen or ibuprofen, before the shot. “A lot of parents think that giving oral pain medications like Tylenol or Advil will help, but they don’t reduce the pain and some research suggests they may interfere with the efficacy of the vaccine,” says Dr. Chambers. You can give pain medication after the shot, though.
Do give your child something to look forward to, such as a treat, after the shot. “With any negative experience, giving your child something positive to look forward to can change the event,” says Dr. Chambers.
Do talk to your doctor about pain management. Dr. Chambers suggests asking “What are you going to do to help my child with pain during this procedure?”
Don’t overly reassure your child. “Parents say ‘It’s okay, it will be over soon,’” says Dr. Chambers, “but study after study has shown that using that type of reassuring language actually makes the pain feel worse.” Research shows that when you tell a child everything is okay, he actually assumes you’re worried about what’s going to happen. “Use neutral language,” suggests Dr. Chambers.
The CMAJ guidelines, which are aimed at medical professionals, also include advice on the actual administration of the vaccine. For example, they say to inject the most painful vaccine last and to avoid aspiration (pulling back on the syringe before injection). Dr. Chambers suggests that parents ask their physicians if they are familiar with the new guidelines for vaccine pain management.