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Fear of needles and injection in children

This article details the causes and measures which can be undertaken to prevent the fear and phobia of needles among children.

Needle Phobia Among Children

Most young children have experience of injections, necessitated either because of vaccination, intravenous cannulation or blood sampling and is one of the commonest fear the children have when they visit hospitals. It is single most important cause of distress among parents also. With expected covid 19 vaccination drive in children, it is likely to become more visible in community. This article details the causes and measures which can be undertaken to prevent this fear and phobia among children.

How common is needle fear and phobia in children?

It is thought that somewhere between 1 in 10 children have needle phobia. Apart from that, minor form of fear is quite common. Fears are common among 4- to 6-year-olds, become even more prominent in 7- to 9-year-olds, and then decrease in in 10- to 12-year-olds.

What are the causes of needle fear and phobia?

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Most of the needle phobia are either because of negative experience during previous needle or from experience of a close family member. It is also related to culture for example, it is quite common for parents to use fear of injection by doctors, to make them behave properly.

What are the means of helping the child or teen cope with the needle?

It is important to understand that Children’s distress during injection is related to the behaviour of accompanying adults. If parents are supportive, most of the children cope without long term issues. The parents can use distraction like mobile or talking about a fun activity they have done recently during injection. They must focus on positives and avoid negative verbal statements. Parents must remain calm and make positive statements. These simple methods are enough for most of the children.

How can the health care workers or hospitals help in needle fear or phobias?

Hospitals, especially children hospitals, have important roles in managing these fear. One of the easiest way is that all injection in children should be only ordered by doctor, if necessary. The injection should also be planned so that all blood samples be drawn in one puncture, preventing repeated needle puncture.

There are pharmacological methods like special skin numbing cream (like the EMLA [eutectic mixture of local anaesthetics]™ or spray like Nummit , which provide local anaesthesia at site of venepuncture. Vapo- coolant spray can also be used to provide rapid relief for short duration.

The doctors or nursing staff can also use special means like transillumination or ultrasound to visualise veins. Wherever long term venous assess is needed, special catheters like mid line or PICC line can be placed. These work for a week or two and child is spared repeated venepuncture.

To conclude, parents, doctors and nursing staff must understand that fear of injection is a natural response and every effort should be done to ameliorate it.