by Valerie Rubin, MD
“Will I get any shots today?” “No shots!” “I’m not ready for my shots!”
These may be some of the first reactions from your child when the pediatrician walks through the door for the well-child check. Though all sorts of important areas are addressed at a well-child visit, including assessments of growth, vision and hearing; a complete physical evaluation; and discussion of nutrition, school success and safety, the young child will most likely remember the vaccinations.
There are many ways that a parent can help a child to face this part of their medical care.
1. Preparation: How should you best prepare your child for vaccinations?
A 2- or 3- year-old is usually best told immediately before or during the visit. Something simple, said in a positive tone, should suffice. “Sweetie, your nurse will give you some shots today. They are little pokes that might hurt for a minute, but mommy or daddy will be here to help you to be brave. You need them to keep you healthy so you don’t get sick.”
A child of 4 years or older should have a little more advance preparation — maybe a day or two before. Explain that they have a doctor’s appointment coming up, where they will likely be getting some shots. Most children entering kindergarten have heard from friends or older siblings about the dreaded “kindergarten shots.”
Explain why they need shots, as children at this age do start to have some more rational thinking. For example, you might say, “We will be seeing your doctor in a few days for your check-up. You will need to get some shots that day. Shots are special medicines that will help you to stay healthy. Most children need some shots before they start kindergarten. They do hurt, but only for a short time. I know that you will be okay, and I will help you to be brave.”
You may want to have them practice breathing and relaxing their arm muscles at home, so on shot day, you can remind them that you practiced this, and they know what to do.
2. Distraction: Give your child something else to think about
During the actual time of vaccination, most children do best if they do not see the needle. Having them actively involved in some quiet activity can help keep their mind off of the pain. Some ideas include: singing a song, telling jokes, blowing on a pinwheel.
3. Speed: Complete the shots, then provide comfort
Sometimes the event is too stressful for successful distraction, but at least the ordeal can be quick. Many children, at the completion of their shots, will say something like “It’s over?” “That’s it?”
Their fear and anxiety about the event is often greater than the pain of the shots. When a number of vaccinations are to be given at once, it is best to get them all completed as quickly as possible, and then comfort the child at the end.
4. Reward: Celebrate the milestone
The sting of the booster shots can be lessened somewhat by a reward, celebrating the completion of this important childhood milestone. Something that a child can share with their parent can be fun — a food treat, going to the park or zoo for the afternoon or seeing a movie.
A prize that is too exorbitant may make the child more fearful of their shots, thinking that “It must be really bad if daddy says he will buy me a new bike for getting my shots.”
5. Parental attitude check: Cool, calm and collected
Try to have a calm, unapologetic, but warm attitude with your child. If one parent is a bit needle-phobic, then perhaps the other parent can accompany the child. If the child has special needs or is very sensitive, then perhaps both parents, or one parent and another support person, could come along. Remember, your school-age child has to learn how to face a number of necessary, but not always pleasant tasks in their life — that is part of growing up.
6. Topical medicine: Numb the location beforehand
An over-the-counter topical numbing cream containing lidocaine can help to slightly reduce the pain of vaccination on the surface of the skin, such as Ela-Max cream. The cream needs to be applied in the appropriate location an hour before the vaccination.
Since many of the vaccinations must be injected deeper, into the muscle, it is not really sufficient to block out all pain. Some families and children do feel better knowing that they are doing all that they can to decrease the pain.
7. Oral pain medicine: Help alleviate soreness
A dose of ibuprofen (Advil), or acetaminophen, (Tylenol), can help a child with some of the soreness they may experience for a day or two after the DTaP (diptheria, tetanus and acellular pertussis) booster. You may give a dose prior to the vaccinations as well.
This Scripps Health and Wellness information was provided by Valerie Rubin, MD, a pediatrician at Scripps Coastal Medical Center Encinitas.