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It Doesn’t Have to Hurt: Strategies for Helping Children with Shots and Needles



The 2024 Global Year will examine what is known about sex and gender differences in pain perception and modulation and address sex-and gender-related disparities in both the research and treatment of pain.

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No parent likes to take their child for shots and needles. So why is it that, despite numerous proven and accessible interventions to manage pain in children, fewer than five percent of children get any kind of pain relief for common needle procedures?

One in 10 children and adults has a significant fear of needles. Many of these fears develop during childhood after an improperly managed painful procedure. Individuals with needle fears often avoid appropriate and necessary medical care, and fear of needles is the number one reason that parents and children don’t adhere to vaccine schedules.  For all these reasons, pain management during routine immunizations is critical.

We have certainly come a long way since the 1970s and 80s when it comes to understanding, assessing, and managing pain in children. Back then it was believed that children, particularly infants and preterm neonates, were too neurologically immature to feel pain. These children often underwent painful surgeries and invasive procedures with the simple use of paralytics, rather than proper analgesia and anesthesia. Looking back, it is hard to fathom how this could have ever been acceptable.

But today, our failure to offer and provide children with evidence-based pain management interventions for common procedures, such as immunizations, illustrates the amount of  work we still have left to  improve the current state of pain management in children.

I have spent the last 20 years studying pain in children. It has been frustrating to observe the huge discrepancy between the quantity and quality of the research evidence that supports these interventions and the striking lack of uptake by health care professionals and the general public to use them. Why is it that most parents are generally unaware that they can use simple strategies like distraction and deep breathing to significantly reduce immunization pain in their children? Why is it that they don’t know that they can use a topical anesthetic cream, applied about an hour before the procedure, to significantly reduce pain? In Canada, these creams are available over the counter at their local pharmacy for about $7 each.

I am a pain psychologist and my husband is an anesthesiologist. We know what proper evidence-based pain care is, and even we have had to demand it for our four children (sometimes in the very institution I work in).  But not every child is as fortunate as mine are, to have pain experts as parents who know enough to demand and expect the best pain care for their children. So, as part of my experience last year in the Mayday Pain & Society Fellowship: A Media and Policy Initiative Program, I decided that I wanted to reach parents directly and empower them to advocate for proper pain management for their children. Together with a team of researchers, clinicians, and communications experts, I created this YouTube video for parents: It Doesn’t Have to Hurt: Strategies for Helping Children with Shots and Needles. We wanted to do something different . . . something that would catch parents’ attention, prompt them to decide to learn more, and to share it with their friends and family. We wanted to make a fun, light-hearted, and engaging new video. In the video a young child advises her mom on some simple things that parents can do—and shouldn’t do—to help make the experience less stressful and painful. Importantly, the tips in the video are all backed by scientific research.

So please help me spread the word.  Watch the video and then please pass it on, to your colleagues, your friends, and your family! Let’s all work together to make pain management easier, for children and for their families!

It Doesn’t Have to Hurt: Strategies for Helping Children with Shots and Needles

You can:

1.             Watch the YouTube video at http://pediatric-pain.ca/it-doesnt-have-to-hurt.

2.              Fill out the anonymous survey at the end of the video.

3.              Share the video with family, friends and other health care professionals, and ask them to fill out the survey. We’re on Facebook!

4.              Tweet the following message: Is your child scared of needles? Watch this video from The Centre for Pediatric Pain Research: http://pediatric-pain.ca/it-doesnt-have-to-hurt #itdoesnthavetohurt

Thanks for your help!

Christine ChambersChristine Chambers, PhD is a clinical psychologist, Canada Research Chair in Pain and Child Health, and Professor in the Departments of Pediatrics and Psychology & Neuroscience at Dalhousie University in Halifax, Nova Scotia, Canada. She is based in the Centre for Pediatric Pain Research at the IWK Health Centre. Dr. Chambers’ research examines developmental, psychological, and social influences on children’s pain, with a focus on family factors in pediatric pain and pain measurement in children.

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