Injections: Tips to Reduce Fear in Children

Blood tests can frighten not only children but also adults. Many times, not only do children find themselves fearful of injections but also their parents, who must show their children able to handle the needle. Ilan Osran, a psychologist in the Institute of Gastroenterology, Nutrition and Liver Diseases at Schneider Children’s, advises how we can help children overcome their fears.

Prior preparation:
One of the most frightening things for children (and adults) is not knowing what awaits them. When the child knows exactly what will happen during a test, he feels more in charge, his level of fear is reduced and there is a bigger chance of cooperation. The child should receive an honest and factual explanation that will diminish the sense of helplessness and prevent any unpleasant surprises. Do not promise the child that “there will be no pain”, rather say that it might not be a pleasant feeling but that it passes quickly. Explain the process of the medical test according to the child’s level of understanding – short and to the point in simple language. Always tell the truth about what awaits the child during the doctor’s visit, which helps the child rely on you in the future. Use dolls when explaining the test to younger children and review the process together using a toy syringe and demonstrating on the doll, or yourself or on the child. It is important to try and understand the source of the child’s fear such as “they will take all the blood from my body”. Ask the child what scares him in order to know what to say to calm him.

Physical coping:
There are various therapeutic techniques that can be learnt in order to calm physical tension during a test. Concentrated breathing for instance can serve as a distraction for the child. Younger children can be told to imagine that they are breathing in calm and strength, and breathing out all their fears. These techniques should be encouraged prior to the test.

Cognitive coping:

In addition to physical calm, words including those used by children themselves can be calming. Think together of some sentences to say repeatedly during the test such as “it’s not such a big deal”, “I can do this”, or “it doesn’t take long”.

Other helpful hints:

If the child has a favorite item that calms him such as a blanket, doll or toy, bring it with to offer a sense of security. Ask him which item will help him most.
Bring something for distraction such as a picture or a game. Some children like to look at your face during the test. You can also sing a favorite song with the child.
Bring a soft toy such as a rubber ball that the child can squeeze during the test.
Give the child a role to play such as holding something, or a choice to increase the sense of control such as which hand to use for the test, or to count backwards from 10.
Youngsters can listen to music they like through earphones to reduce tension and for distraction purposes.
Pain-reducing cream such as Emla (check with your doctor) can be applied to the arm which the child can apply himself to promote control.
Check in advance whether the child will look at the syringe or look away, and add “you can choose yes or no, and if not, I will tell you what is happening”. Most children find it easier to look away.
If a parent is scared of an injection and has difficulty coping, someone else should take the child for the injection.

Processing the experience:

 Comfort the child after the test. Allow him to express his negative feelings and remind him of his bravery. Try to find out what helped the child through the experience and reinforce those coping strategies. If he had a tough time, speak to him and try to understand what might help next time. The child can also be encouraged in front of other people to enhance his self-assurance.

Should your child be very afraid of injections, speak with a psychologist who can work with the child and his parents about coping better with fear. For the most part, therapy of a few sessions is focused on behavioral and cognitive elements which are very helpful in these situations.