Ways to comfort children for vaccine appointments

Contributing Authors:

Young girls looks at arm while a nurse is giving her a vaccine and using a ShotBlocker.

If you’ve ever wished for a way to help your child not feel pain, you’re not alone. We’ve all had vaccines or drawn blood and know it does come with some discomfort. The Child Life team at Children’s Mercy works every day to comfort children before needle procedures like routine vaccines or blood work and they’re sharing ways parents can help prepare kids—and even help kids cope with pain.

Tell kids ahead of time

A big question parents have is if they should tell their child they’ll get a vaccine before the appointment. The answer is yes. Try to always be honest and tell your child, even if they are too young to speak. It helps to keep a relationship of trust between you and your child.

How far in advance you tell your child – days, hours or minutes –is really going to depend on who they are and their coping style. As their caregiver, you know them best. Figuring out how they react to vaccines, stress, anxiety or where they are developmentally, will vary greatly from child to child. For example, a 2-year-old child may not need a week’s advance notice, but a preteen who likes to process things might want to know ahead of time. A preteen who struggles with anxiety may only need an hour heads-up, based on how you know they will react.

Try to think through past medical experiences, coping skills, how quickly they become upset and stay upset. How quickly do they process things and return to a neutral reaction? Have they asked to be prewarned before needle procedures? All those things you notice as a parent should be thought through when figuring out when to tell them.

Choose the right words

Words can have different meanings. Children can hear a word and be confused or not understand the way it was meant. When preparing for a vaccine, there are some better words to use.

Try to say poke, not shot. Shot is often used in place of the word vaccine. By using the word poke, it helps to more clearly share what may be felt and not cause confusion.
Explain what will happen. Share what is about to happen. The nurse is going to give you medicine with a poke.
Avoid describing what else it will feel like. Often, pokes are described like a bee sting or other similar metaphors. Bee stings can hurt for a while and some people may be allergic. While well-intended, this example and others could cause confusion. Instead, try something like, You will feel a small poke.
Try not to assume their feelings. Parents commonly ask if their child is scared or worried. This may be putting thoughts into their head they were not feeling. Ask the child first, instead of implying. You can try a question like, How are you feeling? Was it what you thought it would be?
When, then statements. Try phrasing things so the child knows what is going to happen, and what comes next. When we get your medicine, then we will go get ice cream after.

Let kids take part

Children as young as one can join in their health care, even a little bit. When a child is able to choose parts of what will happen to them, it helps bring a calming effect, sense of control and helps them cope with future health care events. Here are some ways to get them involved:

Pick which arm the vaccine goes in.
Choose a numbing technique.
Choose a comfort position.
How should mom/dad be involved, help or not?
Look at the vaccine or look away.
Keep eyes closed or keep them open.
Pick a way to stay distracted.

Ways to comfort by age

To help needle procedures feel less painful, there are a few ways to help, from how to numb the pain, comfortable positions and keeping the mind distracted. Here are some different ways by age group.

Age	Ways to numb	Comforting position	Use a distraction
0 to 12 months	Try a cold spray to numb the skin or a ShotBlocker® to help distract pain signals to the brain. Breastfeeding or sugar water on a pacifier also helps children feel less pain by blocking pain receptors in the brain.	Swaddle or hold your child during the poke to help them feel close to you.	Books, music, rattles, toys with noise, singing, cooing and making eye contact.
1 to 5 years old	Try a cold spray to numb the skin or a ShotBlocker® to help distract pain signals to the brain.	Having your child sit upright will let the child feel a sense or control. Or hold your child in your lap and keep them still.	Pop up books, music, rattles, light up toys. Helping them take deep breaths, pretending to smell flowers and blow out birthday candles.
6 to 18 years old	Try a cold spray to numb the skin or a ShotBlocker® to help distract pain signals to the brain.	Having the child sit upright will let the child feel a sense of control. Hold or be next to your child. If they are older, ask them what position feels best.	Phones, music, video games or talking to your child about an upcoming special event may help.

Over-the-counter numbing creams, cold spray and the ShotBlocker® may be purchased from most stores or online. You can also ask if your vaccine location offers these items on-site.

Know feelings happen

It’s OK for your child to have big feelings or be upset. Crying, stomping or screaming are all common ways for children to react at any age. Kids get upset, and it’s OK. Try not to react back, but instead, validate their feelings and be a safe and comforting place when they are upset.

Learn more about making needle procedures more comfortable for children here.