Key takeaways

Needle fear in children can lead to avoidance of necessary treatments, potentially causing life-threatening health outcomes, especially in children with chronic illnesses.
Effective strategies to reduce needle fear include using distraction techniques during injections, such as watching a show or playing games, and involving the child in the process by offering choices when possible.
Creating a positive injection routine, using special items like favorite candies or toys for comfort, can help children cope with the stress of regular injections.
Finding support through communities, support groups, or connecting with others facing similar challenges can be beneficial for both children and their parents in managing the emotional aspects of chronic conditions and treatment.

Like most kids, my daughter spent her early childhood years afraid of shots. She would ask before every doctor’s appointment if she would be getting one that day, and if the answer was yes, there were always tears—and lots of dread.

So when she was diagnosed at the age of 4 with Juvenile Idiopathic Arthritis (JIA), a chronic condition that would require her to receive weekly injections, likely for the rest of her life, I was the one who panicked.

How was I supposed to subject her to weekly needle sticks at home?

“Needles are among the most feared experiences of children,” says Frank J. Sileo, a licensed psychologist and founder of The Center for Psychological Enhancement in New Jersey. “Needle fears and phobias begin in children around the age of 5.5 years. However, children with chronic illnesses are particularly at risk … if they avoid or refuse treatments that involve needles, it can lead to poorer health outcomes that may possibly be life-threatening.”

That was my concern for my daughter. If we didn’t get off on the right foot from the start, would she develop a fear of needles that might cause lifelong health consequences?

How to help your child stay calm during an injection

Assuaging your child’s fear of needles starts with you: “Parents have to not show any emotion,” recommends Dr. Kathleen Bethin, an American Academy of Pediatrics (AAP) spokesperson. “If parents act like they are afraid or they act like they are sad, the kid is going to pick up on that.”

Specializing in pediatric endocrinology, Dr. Kathleen Bethin often helps families adjust to regular injections when a child is diagnosed with any of the many chronic conditions that could require injectable medication, like:

Asthma
Allergies
ADHD
Epilepsy
Diabetes

And it’s important to refer to them as injections, not shots, because of the negative connotation some kids already have with shots.

And above all communication is key. Leading up to my daughter’s initial injections, I spoke with her about what to expect. We came up with a plan—one we executed with a trip to Target. We purchased special Band-aids (in our case, Frozen ones), a miniature Spider-Man ice pack, and candy: Sour Patch Kids for during the shot (which I’d heard could serve as a bit of a taste bud distraction) and M&Ms for after.

I also signed up for a JA Power Pack from the Arthritis Foundation, which included a stuffed bear named Champ, who she could cling to when receiving her injectable medication.

How to give a child an injection

Dr. Sileo says that the use of distraction is one of the “most-studied and empirically supported methods for helping children with needle pain.” He suggests parents help distract their children from impending injections using a variety of tools, such as:

watching a television show
listening to favorite songs
playing games while injections are given
reading a book
watching YouTube videos
having them blow bubbles
squeezing a ball
looking through a kaleidoscope

For us, the distraction came in the form of a Sour Patch Kid, popped in her mouth right before the injection, or a FaceTime call with her grandparents. That’s what we did for the first few months. Now my daughter coughs on the count of three, right before I give her the injection. It’s just enough to prevent her from feeling the needle going in.

We were lucky. My daughter and I created a routine that made her injection nights relatively easy. She shed a few tears in the beginning, but she never fought me. And after just a couple of weeks, she started to feel pride in her own injection bravery. Today, two years into weekly injections, she loves having an audience on injection night—if only so that she can show her friends how tough she is.

But not every family has this experience.

How to deal with injection trauma

That was the case for Bree Frederickson, whose daughter was diagnosed with JIA at 2 years old. Frederickson says her daughter handled her shots like a champ—at first. They developed a routine that involved a stuffed animal, special Band-aids, and her favorite dinner, but when her dose changed, so did the ease of injection.

The new medication came in pre-filled syringes that had a preservative in them; the preservative caused a burning sensation that made the injectable medication hurt more than ever before.

Fredrickson said her daughter—now 4 years old—made the choice to switch to two injections a week instead of one, purely so she could stop being given the injection with a preservative in it.

There’s something to be said about choice; and giving kids (even young kids) a say in their injection nights can mean a lot. At least, whenever there is an option to do so.

Still, injection trauma can be very real for some kids. I’ve spoken to families who have to bring their little ones to the doctor for shots every week, purely because they kick and fight and scream so much that it can’t be done at home.

Finding your village

I’ve found that joining another child for an injection sometimes helps when other strategies don’t work. While my daughter always did well with her at-home injections, her regular blood draws were a different story. She has hard veins to find, and she required multiple sticks on more than one occasion. After a few visits like that, her fear of blood draws multiplied.

The one thing that finally made a difference was joining a friend from arthritis camp for her blood draw. After watching her friend react calmly to getting her blood taken, we then developed a different routine for my little girl: Her blood draw would now happen in her hand, instead of the crook of her arm (where so many missed needle sticks had taken place), and her favorite nurse would be the only one doing it from now on.

The combination of seeing her friend react bravely to a blood draw and being able to design a new routine where she felt—at least somewhat—in control made all the difference in the world. My daughter hasn’t panicked over a blood draw since, even though we’ve had a few more instances of missed sticks.

We were able to return the favor a few months later when a newly diagnosed little girl was struggling with her own injections. We went to her home on shot night, and my daughter proudly showed off how she helps draw the medication for her own injections and the routine we have for getting those injections done.

A few weeks later, that little girl’s mom told me their shot nights had dramatically improved ever since.

Sometimes, what these kids need more than anything is to simply know they aren’t alone in this.

And you know what? Sometimes the parents need that, too. So if you are parenting a newly diagnosed child, seek out that support. Find Facebook groups dedicated to parents of children with your child’s condition. Talk to your child’s doctor about support groups in your area. Attend camps and conferences whenever possible. And build up a support system of other parents who are walking the same walk as you.

Time and time again, you’ll find this community is where you turn the most when you’re dealing with the struggles of your child’s condition—and that includes helping you problem-solve ways to make injection night as easy as possible.