What Can Parents Do About Needlestick Fears?

She is so petrified; she’s terrified of needles. I don’t know where that came from. [Initially], she wasn’t afraid of needles. But somewhere along, between then and now, she’s terrified of needles.–Parent of a child with cancer, age 11 (Hildenbrand et al., 2011)

Approximately 50-60 percent of children report needle fears when faced with immunizations. Twenty to 75 percent of children with chronic medical conditions suffer from needle fears (Orenius et al., 2018). That’s millions of children in the United States alone.

With many medical recommendations, including regular vaccinations and chronic medical conditions requiring shots as part of treatment or frequent bloodwork or port access (which can bring up similar fears), needlestick fears can bring additional stress to kids, parents, and medical teams.

As we approach flu vaccination season and have ongoing recommendations regarding COVID-19 vaccines and booster shots, some kids and parents may dread these vaccination appointments.

The good news is that while these fears are very common, parents can partner with medical teams to help their child gain confidence and overcome these fears.

Three tips to plan for your child’s next needlestick:

1. Plan when to schedule the appointment (if you can): When is the best time to schedule the appointment? Does your child do better getting up in the morning and getting it over with? Or do they do better later in the afternoon once they’ve settled into the day? What time of day will your family feel less rushed?
2. Plan what will happen before the appointment: For some kids, it can be helpful to plan out the whole day (and even the night before if they have lots of fears) leading up to the needlestick. This can include what to eat for breakfast, what to do on the way to the appointment (for example, listening to their favorite music), and what to do in the waiting room (for example, reading their favorite book or watching a specific show on a tablet).
3. Plan the needlestick ahead of time:

• Choose one person to speak quietly and comfort your child during the appointment. Try phrases like “You can do this,” “You got this,” or “I’m here for you” instead of “It won’t hurt.”
• Choose a distraction with your child before the appointment. For example, listening to music or watching a show on a tablet.
• Include a relaxation strategy. For example, taking a deep breath and pretending to blow on a cookie to cool it down or making a pinwheel spin.
• Plan a reward. Set a small goal for the needlestick. Be clear about what your child needs to do to earn the reward. For example, it may be okay for your child to cry but not to yell or kick.
• Ask your medical team if they have any strategies that can help. Some teams have numbing creams or other distraction devices that can help.
• Share your plan with your child’s medical team.

For some kids, it takes time and practice to start to overcome their needle fears. Try your best to stay positive and praise your child for any part of the needlestick process that worked. For example, did they stay calm in the car on the way there? Or in the waiting room? If it doesn’t go well this time, adjust your plan and keep trying.

Of note, some children have needle fears that they may need extra help from a professional to overcome or to cope with. This may be particularly important if your child has a medical condition requiring frequent needlesticks. If this is the case for your child, talk with their pediatrician to see if they can help or refer you to a mental health professional to teach your child skills they can use to deal with their needle fears.

I Want to Know More

Here are some resources to learn more:

• Afraid of the Doctor: Every Parent’s Guide for Preventing and Managing Medical Trauma: Many of the strategies described in this book can be used to help parents manage needle fears/pain. For example, check out chapters on planning head (chapter 14), communication (chapter 15), using distraction (chapter 23), using positive reinforcement/rewards (chapter 24), and body control (chapter 25).
• Solutions For Kids in Pain (www.kidsinpain.ca): This website provides information for parents, healthcare providers, and researchers on strategies to help manage children’s needle fears. The resource offers videos, blogs, links to additional resources, and summaries of the science behind children’s pain management.

The ideas in this blog and resources are not a replacement for mental health care. If you are worried about your or your child’s behaviors or emotions, reach out to your doctor for help.

To find a therapist near you, visit the Psychology Today Therapy Directory.