By Marté J. Matthews, MA, LMFT
Receiving injections and having blood draws can be quite an ordeal for children and for their parents. Needle phobias are very common in childhood but remain one of the most prevalent phobias among adults also, affecting at least 10% of the adult population. It is thought to be the leading cause of avoiding necessary medical treatment among adults.
Needle phobia is not a behavioral problem. Incentives aren’t usually helpful if it is an actual phobia. Punishments will certainly make things worse.
It is important to know that while many children become very upset about these medical procedures and some do not, that either reaction is completely normal during childhood. What we want to try to do is prevent normal developmental fears from becoming lifelong phobias. The worst part is the anticipation for most people. Some of the strategies here can help parents support their child with injections and blood tests. Take some time to talk with your child before the appointment about these ideas to formulate a plan to address the fears together.
BEFORE:
Do practice relaxation strategies. Slow deep breathing, tensing and relaxing muscle groups, and doing other effective relaxation strategies will lower stress for everyone.
Do not chat with other people about your child’s anxiety in front of your child, even if you think it doesn’t matter. This is only likely embarrass your child, on top of already overwhelming feelings of worry and fear.
Do not lie to or deceive your child about any test, pretending it might not be needed or falsely reassuring your child it won’t hurt or be uncomfortable. If you are not truthful, then your child will learn not to trust you.
Do not tease or shame them for their feelings. Feeling shamed, knowing you are frustrated with them will make them feel worse in a situation that is already hard to cope with. They can’t be expected to behave better if they are feeling overwhelmed.
Do not laugh or chuckle about their tears or clinging. They need you to be kind and supportive right now.
Do offer comfort and reassurance, a hug, a comfort object, or distracting activity. If permitted at this point in the visit, offer a cold drink or popsicle.
Do ask the child what they are expecting to happen. Even if the visit has been explained, see if their understanding is accurate. Some kids do understand what is happening; others may be confused, causing more anxiety than is necessary.
Do respond with kindness, for example: “That sounds about right.” Or “Almost, and the other thing is…” or “It sounds like you’re feeling pretty scared about it. I sure hope it isn’t that bad!” No matter what assure your child you will stay with them to hold them, comfort them, and celebrate when it is over.
Do prepare a few distractions for the appointment: “Let’s bring out the book we brought.”
Do try some strategies for reassurance: “We have gotten through this before, and we can do it again this time together. Remember what helps…”
Do stay calm, breathe deeply, and practice your own self-calming. When parents are upset, we won’t be at our best. Children will pick up on your feelings too, and they will feel worse that the situation warrants.
Do seek out medical providers that will be helpful, not just with a single medical procedure, but with a plan to support your child to have less volatile emotional responses to procedures in the long term. If your doctor’s office is not handling the situation well, talk about it with your doctor and the nurse manager. If they are not helpful, carefully consider if this is the best doctor for your child.
Numbing cream and products like Buzzy Bee (www.buzzyhelps.com) may be helpful. Try it if your child wants it, even if you don’t think it will matter.
Do educate yourself about needle phobia. One of the most thorough websites to help adults with needle phobia, and the parents and spouses of those with needle phobia is: https://www.needlephobia.com/
If your child is defensive, reactive or refuses to even talk about it with you, is not cooperative with making a plan to get through this more easily, consider psychotherapy with a therapist who is experienced with treating needle phobia.
DURING:
During the blood draw, the job of the staff is to work quickly. They may try to calm the child, but this will only slow things down. The more you can support your child, the faster the staff can work. Getting it done smoothly and safely is important to helping make this an experience to balance out the child’s negativity and fears.
For those who get light-headed, or have a history of fainting with needle procedures, it is important to inform the medical staff about this. They will likely have you lay down for the procedure for everyone’s safety.
You may find that if you watch the procedure, your child will try to look too, which may be more upsetting for some children. On the other hand, some children do feel more in control, or even interested, when they can see what is happening. Help them decide ahead of time which way they want to get through the blood draw or injection.
Support them to take steps to cope well. Help them stop doing things that don’t help them cope, and redirect them to use the ideas you planned.
Parents can try:
holding your child’s hand, face/head or body against yours
offering comforting snuggles
offering a little distraction like singing a tune together, watching a video or reading
offering encouragement
reassuring them that it is almost over
holding your child’s face gently or cup their chin lovingly, stroke your child’s hair
keeping their gaze on you
keeping your voice calm and quiet. Speak clearly.
practicing slow deep breaths together
Counting the seconds “one hippopotamus, two hippopotamus…” or counting watermelons can help. Most tests and shots feel like they take a long time, but actually last just a few seconds.
AFTER:
Do not shame, tease or scold someone for having strong feelings or even for screaming or crying, even if their behavior seems extreme. Your child is probably already embarrassed for having made such a fuss. Avoid all “I told you so,” language or attitudes. If anyone humiliates a person with needle phobia, teases them or laughs at them, they are likely to feel defensive, and “dig in” to justify their extreme behavior. This will make future situations worse. Make it clear to the other adults and to any siblings of the child that teasing about this is not OK.
Do express relief that the blood draw is over, offer comfort and reassurance and hugs.
Do praise your child if there is anything about your child’s behavior that was positive. “I noticed you took some slow, deep breaths with me. I’m so proud of you for being so brave!”
Do debrief the incident after they have been calm for awhile: “On a scale of zero to 10, how bad did it turn out to be?” If the child insists it was horrible, simply say, “I’m sorry it was so awful. Let’s do (something you enjoy) to help you feel better.” If the child says the blood test wasn’t so bad after all, calmly express relief: “I’m glad it wasn’t as bad as you expected it to be. Next time, we’ll remember it’s scary to know it’s coming, but it turns out not to be too bad. I’m so proud of you for being so brave.”
If you have a family member, an adult or a child, who shows a great deal of distress, or really dreads injections or blood draws, a therapist can meet with you and the person with the phobia to describe how child and family therapy can help. This is a team effort, and will require work on everyone’s part. If this phobia is the only problem worked on in psychotherapy, the fears can usually be addressed effectively within a couple of months. Children and even adults can get the medical procedures they need with less fear.