Are you wondering how you can help your baby during her vaccines, shots, blood draws & IVs?
It's easy to feel powerless, as though there's not much you can do to help your baby.
Guess what?
There's more you can do than you probably think!
AND
There are ways you can actually help decrease your baby's pain during that awful poke!
I have 8 different research-based interventions to help your baby feel more comfortable during these injections!
WHY BABY NEEDS TO BE COMFORTED
AND HAVE PAIN REDUCED DURING NEEDLE PROCEDURES
Before we dive into my tips to help baby during needle procedures, it's important to understand WHY baby needs your help in feeling less pain.
Believe it or not, some new research found that these are some common beliefs among medical professionals in regards to needle procedures:
"Needles aren't very painful."
"It's best if I'm fast and accurate."
Medical professionals also reported that they give low priority to needle pain.
Interestingly, children report routine needle procedures as being their greatest source of pain and anxiety!
But what about babies?
Babies experience unnecessary pain during routine procedures according to the 2016 American Academy of Pediatrics guidelines for procedural pain in neonates.
We know that the pain premature babies endure during procedures can have long-term negative effects on them such as: increased morbidity and mortality, higher reported pain self-ratings for school-age kids during injections, and poorer cognition and motor function, to name a few!
Research is telling us that babies need adequate pain management to avoid these long-term negative effects, however, pain management strategies still aren't widely offered or used in most outpatient and inpatient hospital settings!
I want to change that!
Let's learn about 8 ways you can decrease your baby's pain during shots, blood draws, IVS, and vaccines!
HOW YOU CAN HELP YOUR BABY FEEL
LESS PAIN DURING VACCINES
& OTHER NEEDLE PROCEDURES
1. Simultaneously Inject
If your baby requires more than one needle, ask staff to simultaneously inject them!
Vaccines are a great example of when you would need vaccines injected simultaneously!
During several of baby's well-check appointments, baby will receive more than one vaccine, requiring more than one injection (shot).
Rather than having baby feel the pain of one injection and then waiting for the nurse to place the band-aid, switch to the other side of baby, get the next shot ready, and then inject the second (or third) shot causing baby to feel pain again and again (and sometimes again), talk to your medical provider about simultaneously injecting baby's vaccines!
What this means is waiting for two staff members to be available to help administer baby's shots at the same time!
This looks like one nurse on each side of baby's body, ready to inject the vaccinations into each of baby's legs simultaneously.
You might be thinking about how painful that sounds to experience both shots at once.
Interestingly, simultaneously injecting tricks the brain and actually reduces baby's pain.
It's not too much for their bodies to handle at one time (source).
If another staff member isn't available to help with simultaneously administering vaccines, ask your medical provider to inject the most painful vaccine last.
Studies show that injecting the most painful vaccine last reduces pain felt at the time of the injection!
Which vaccines are the most painful?
The MMR II and Prevnar are the most painful vaccines.
Save those bad boys for last and you've just decreased your baby's pain!
2. Apply EMLA Cream Before Injections
(for babies over 1 month old)
EMLA Cream is a topical anesthetic (contains lidocaine and prilocaine), which means it numbs the skin, decreasing the amount of pain felt.
It's been safely used for several years (I used it to get my ears pierced).
How to use EMLA Cream?
The cream is simply applied to the area of skin where the child will receive the vaccine.
A bandage is applied on top to keep the cream in place for at least 30 minutes.
EMLA cream does not begin working before at least 30 minutes, and usually best effect is around an hour.
After the wait for the cream to take effect, the bandage is removed and the cream is wiped off.
The skin is now ready for the poke!
Simple enough?
There's lots of research suggesting a significant decrease in pain felt when EMLA cream is used.
Ask your doctor about ordering an EMLA prescription for your child.
In some countries, EMLA can be purchased over the counter.
I know this is true in Canada!
Either way, be sure to check with your doctor first before using EMLA cream for a few reasons:
1. Some kids with complex medical histories can't have EMLA cream.
2. Babies under a month old also cannot safely use EMLA cream.
3. The office might want you to apply the cream in a couple different areas so ask the office where to apply the cream. Make sure you place the cream before going to the doctor's office so you don't have to wait for it to take effect in the office (we all know the office would not be happy about waiting for you). If your office doesn't want you applying it or the EMLA cream is offered in your doctor's office, you can have them apply it in the office, just be prepared to wait for it to take effect, so your office might have you come a half hour earlier than your appointment time. Also be sure the staff doesn't try to start the injection prior to the peak effect time (remember it's 30-60 minutes after application)! Kindly ask for them to wait for it to be fully working before they begin.
3. Use a Comfort Position During Injections
My favorite, and one of the simplest, most important ways you can help reduce baby's pain at the time of injection, is to use a comfort position!
Research suggests comfort positions decrease the pain felt during vaccinations and other needle procedures!
So why are we still pinning kids down?
Not only will this comfort baby during his/her vaccine, but using comfort positions throughout baby's medical experiences will help baby to have more positive experiences at the doctor leading to less fear and anxiety for future visits!
Are you new to comfort positioning?
Read my post on the Benefits of Comfort Positioning for Medical Procedures and then learn How to use Comfort Positioning.
Be prepared to educate your medical staff about comfort positioning since many doctors' offices do not use comfort positioning as their standard of care.
It might be new to them, so share the research and don't back down if you get a "no!"
There's absolutely no reason a baby couldn't be held during a vaccination, shot, blood draw, or IV procedure!
4. Breastfeed Your Baby During Needle Procedures
**This one may not apply for baby getting an IV. Talk to your healthcare provider to determine if breastfeeding can work during the IV placement. The team will likely need better access to baby's arm than this position provides.**
Did you know you can breastfeed your baby while baby is getting her vaccines, shots, & blood draws?
You can.
And if you're breastfeeding baby, you should!
I'll tell you why.
So many research studies suggest that when babies breastfeed during procedures they actually feel less pain!
I have a whole post on Why You Should Breastfeed Your Baby During Vaccinations so be sure to check that out for a full list of benefits and research!
Breastfeeding has an analgesic effect on babies, which means it acts like a painkiller!
It's also been found to be more effective in decreasing pain than just using a pacifier, so do your best to time it right so you can breastfeed your baby during her procedure.
If the timing doesn't work out, don't stress!
Pacifiers are effective, too! (more on them below)
Not breastfeeding?
Don't sweat it.
You can comfort baby after the poke with a bottle!
Currently, there's no research showing it's safe to give baby a bottle during vaccines, so I cannot recommend doing that!
Here's another great option for you instead...
5. Use Sucrose or a Sucker Before and During Injections
Sucrose (sugar water) has an analgesic effect on babies, which means it acts similar to a painkiller.
Sucrose is widely used; lots of babies in the NICU get sucrose for their procedures.
Ask your medical provider if they have sucrose available (the sooner you ask, the better).
Also, be sure to ask your medical provider what the correct dosage is for your child, especially if your baby is a premie!
Dosage is based on weight and premies have a different dosage chart than other infants.
The most important part of dosing your child is that the first dose needs to be given
TWO MINUTES PRIOR
to the procedure in order for the sucrose to be effective.
Then you can give the next dose right before the vaccine is given and then place baby's pacifier (if using) in her mouth.
If the procedure lasts a while, you can continue to give more doses as recommended by your physician.
Some studies suggest that sucrose can be beneficial up to 18 months, but most suggest up to 12 months.
It appears not much has been studied past 12 months, though.
Don't have sucrose available?
If your doctor's office or hospital doesn't have sucrose readily available, some pediatricians provide suckers instead (or you can bring your own).
If you don't have sucrose and don't want to use a sucker, you can breastfeed (most effective in reducing pain) or use a pacifier (still an effective pain-reliever)!
More on pacifiers below.
6. Give Baby a Pacifier During Needle Procedures
Non-nutritive sucking helps babies feel less pain during procedures!
Bring your pacifier and allow baby to suck before, during, and after the procedure.
7. Provide Distraction Items for Baby During Vaccinations
Babies over 3 months old can benefit from having a toy to distract them!
If you have an additional support person coming with you to the appointment, you could have that person hold your distraction toy, which would be a great help to you since you'll be holding baby in a comfort position.
If you don't have any extra helpers, don't worry about using your distraction item during the shot because you'll be too focused on keeping your comfort position safe and secure, but you can use a distraction toy before and after baby's vaccine!
My favorite distraction items for babies are:
1. Bubbles
Grab some bubbles here
2. Light spinners
These fun light-up toys are quick attention grabbers, especially for babies and toddlers. Remember, they will only be effective if they are novel. So stash one away and only bring it out for baby's doctor appointments so it can help you in your time of need!
3. Your voice!
Sing or talk to baby! Never underestimate the power of your voice!
You can see all my favorite distraction items by clicking here.
8. Bring Baby's Comfort Items
Does your baby love a blanket, lovey, or stuffed animal?
Bring it with you to help comfort baby before, during, and/or after the shot, IV, vaccine, or blood draw procedure!
These items of comfort will help baby deescalate and come back down to baseline after the procedure so you can (hopefully) leave the office without a screaming baby!
Checklist - What to Bring For Baby's Vaccinations
It's important to be prepared!
Taking a baby anywhere requires a lot of planning, and let's be honest, babies require a lot of stuff!
To relieve your brain of having to keep track of all the things you'll need to bring for baby's appointment, I've made a checklist for you right here!
WHAT TO BRING FOR BABY'S NEEDLE PROCEDURE
1. EMLA cream (check with doctor first)
2. Nursing / Breastfeeding cover (if used)
3. Practice your comfort position and be ready to educate your medical staff
4. Sucrose or sucker (learn from me- bring an extra shirt for baby because of drool!)
5. Pacifier
6. Bottle & formula for after baby's shots (if not nursing)
7. Baby's blanket, lovey, or stuffed animal
8. Distraction toy (light spinner or bubbles)
9. Baby's vaccination card :)
Feeling ready now?
I hope you feel empowered to take on your baby's vaccines with your toolbox ready to help baby feel less pain!
Will baby still cry?
Most likely.
Will baby have a more positive experience that translates to less anxiety and fear for future medical experiences as baby grows?
Yes!
Keep using the simple Child Life interventions I'm sharing with you and your child will be better able to cope with difficult medical experiences!
You've got this!
-Kara
I would love to hear how your experience goes!
Please find me on Instagram and tell me your experience.
**My posts are for educational purposes only and do not constitute professional medical advice.**
SOURCES
A hospital-wide initiative to eliminate or reduce needle pain in children using lean methodology
Analgesic effect of 30% glucose, milk and non-nutritive sucking in neonates.
Analgesic effect of breast feeding in term neonates: randomised controlled trial.
Analgesia with breastfeeding in addition to skin-to-skin contact during heel prick
Breastfeeding as a Pain Intervention When Immunizing Infants
Breastfeeding for procedural pain in infants beyond the neonatal period.
Centers for Disease Control and Prevention: How to Hold Your Child During Vaccination
Centers for Disease Control and Prevention: Vaccines For Children - Make Shots Less Stressful
Comparison of analgesic effect of direct breastfeeding, oral 25% dextrose solution and placebo during 1st DPT vaccination in healthy term infants: A randomized, placebo controlled trial
Does breastfeeding reduce vaccination pain in babies aged 1 to 12 months?
Efficacy of Breastfeeding on Babies' Pain During Vaccinations
Reducing the pain of childhood vaccination: an evidence-based clinical practice guideline
The Use of Breast-feeding For Pain Relief During Neonatal Immunization Injections.
World Health Organization position paper: Reducing pain at the time of vaccination
World Health Organization - Six Common Misconceptions About Immunization
