Parent's Guide to Pain Prevention

Does this situation sound familiar?

"You have a doctor appointment for a check-up today after school"

"Am I going to get a shot? I hate shots. I don't think I want to go to the doctor today"

Before the age of 2 years old, the CDC recommends children receive 24 immunizations. While this sounds like a lot of shots, and it is, immunizations are one of the Public Health initiatives that have resulted prevention of the most deaths and disability early in life. Often children need sports physicals, annual check-ups or other appointments to ensure they are up-to-date on their health care needs. Not all of these appointments will require immunizations or blood draws, but children become focused on that task early in life. There is a phrase in pain management that I have adopted as my personal mantra — "If you can anticipate pain, you can prevent pain." On a daily basis I work with students, staff and families to learn how to anticipate and prevent (or reduce) pain in everyday life. Pain management is not just about medication, today there are many tools available to help control pain. Here are some tips to prevent (or reduce) pain:

Infants The Five S's

• Swaddling

• Side/stomach position

• Shushing

• Swinging

• Sucking

Infants

The Five S's are frequently used to comfort a crying infant. Typically injections are given in the thighs and blood draws are often heel sticks in this age group. By swaddling their upper body and leaving their legs out, you can provide some comfort for the baby. Laying them on their side and shushing or singing quietly in/near their ear can also provide comfort. Allowing them to suck on a pacifier alone or with sugar water (sweet ease™), formula or breast milk can provide pain relief during the procedure. Allowing them to breastfeed during the procedure has been shown to provide great pain relief. Finally, gently swinging them after the poke can help to calm them after the procedure.  While we may not be able to use all of these techniques with every infant, think about which ones will be appropriate as you prepare for your next well baby check-up.

Older infants to toddlers

Music provides pain relief in a couple ways. Many times music evokes an emotional response, it can trigger memories or it can relax or excite us. Music is a great tool to use during painful procedures like needle sticks. If you have a smart phone, music can be easily found through a variety of applications, websites or music downloads. If you have ear buds available that can increase the success of relieving the child's pain. If you do not have an electronic device, you always have your voice and your child's voice. You might choose to sing or hum a song that is soothing to the child or you may choose one that is fun and upbeat. Once they are old enough, ask the child to sing along and tap the beat with their finger, hand or toes. The more you involve them, the more successful the music will be!

Toddlers through teenagers

Distraction is a big word for dividing someone's attention from one task to multiple tasks. Take the child's attention off the object of pain (needle poke) and distract them with something fun. The items that can be used for distraction are almost limitless — books, movies, games, applications, and other toys. You can bring a book with you that your child has not seen recently, or a new book they have never seen.  While you read to them, ask questions about objects on the page. If you forget to bring a distraction item, most clinics that cater to pediatric patients will have something available that you can borrow.  Look around the room you are in — is there a picture you can ask your child about? Or a fish mobile to have them watch? Do you have a cell phone with applications the child likes? Are there books or magazines in the waiting area they can bring with them to read during the procedure? Use your imagination; unless you are in a solid white room, the available distractions are limitless!!

Buzzy Bee A final option to consider is Buzzy Bee. It works by using cold and vibration to make temporary changes to the central nervous system that works to prevent the pain signal from getting through to the brain. It is cute and fun to look at, so it also provides some distraction. Buzzy Bee is available at many UW Health locations and you can request it for flu shots, vaccinations or blood draws - just ask when you check in at the clinic.

Buzzy Bee is also available for purchase in the UW Health outpatient pharmacies and at the Gift Shops. If you cannot find one locally, Buzzy can be purchased at https://paincarelabs.com/pages/buzzy.

What are some ways you comfort or distract your child during needle pokes?