As we recognize National Immunization Awareness Month, August is an important time to ensure you and your children are up-to-date with their vaccines. While getting a shot can be frightening for people of all ages, the right preparation and support can make the entire process less stressful.

Strong and Steady: Supporting Infants Through Their Immunizations

• Plan ahead: It may be best to schedule your baby’s appointment for a time when they are well-rested and fed. A tired or hungry child is more likely to be irritable and anxious. Before the poke, make sure to undress your baby to free the leg(s) or arm(s) where the needle will be given.
• Breastfeed your baby: If you are breastfeeding, start to breastfeed your baby before the poke. Make sure you have a good latch. Then continue breastfeeding during and after the needle. Feeding combines holding, sweet taste, and sucking and is a great way to help comfort the baby.
• Other options:
  • Sweet water solution: Sometimes, medical offices have Sweet-Ease, an oral sugar (sucrose) water solution, that you can put on an infant’s pacifier to help decrease the pain. Ask your doctor if this is a good option for your baby. Give it 2 minutes before the poke. This sweet solution can also be made at home by mixing: 1 teaspoon of white sugar with 2 teaspoons of distilled or boiled water. You may also dip a pacifier into the sugar water and give it to your baby before, during, and after the poke.

• Ask About Numbing Cream: Numbing cream/patches may not be available in all vaccination settings, but you can inquire about it ahead of time or request it upon check-in. Topical anesthetics such as EMLATM, AMETOPTM, and Maxilene may be available for purchase from pharmacies without a prescription. Apply it early, as it needs about 30-60 minutes to take effect.
• Suckling: Whether it is the bottle, the breast, a pacifier, or the thumb, engaging in suckling can help calm and soothe the baby.
• Comfort toy/blanket: Bring a familiar toy and/or blanket that could be comforting to the baby. It can help the baby feel safe and secure.
• Use comfort positioning: Comfort positions can make a big difference. Holding the baby close to you (skin-to-skin if possible) can offer calmness to your baby. Talk to them in a calm, soothing voice. See images below (from Meg Foundation) for comfort positions ideas.  

Brave and Ready: Supporting School-Aged Children

• Plan ahead: Before the appointment, plan ways to help your child cope by letting them choose to bring a comfort item from home to their appointment or choose what they would like to do during the visit for distraction.
• Discuss ahead of time: Timing is important when discussing immunizations with your child. For younger children, it’s best to explain the procedure the day of or the day before the appointment to avoid prolonged anxiety. Older children, however, benefit from having a conversation a few days in advance. This gives them time to ask questions, process the information, and feel more prepared for the visit.
• Comfort positioning: Research shows that children are less fearful when positioned in a sitting position. Allow your child to sit up on the exam table, rather than laying down, to alleviate some distress. If allowed by the medical team, sit with your child in a supportive comfort position, allowing you to assist with holding and support in close
  proximity.
• Bring buzzy: Buzzy, the vibrating bee, offers a vibrating (and ice) sensation near the site of the shot(s), which can help reduce pain.
• Use distraction techniques: During the procedure, distract your child with engaging activities. You can play with toys, play “I Spy”, watch a video, play a game on a phone or tablet, or encourage them to deep breathe, count, blow bubbles or sing. The key to distraction is to let it distract!
• Ask About Numbing Cream: Numbing cream/patches may not be available in all vaccination settings, but you can inquire about it ahead of time or request it upon check-in. Topical anesthetics such as EMLATM, AMETOPTM, and Maxilene may be available for purchase from pharmacies without a prescription. Apply it early, as it needs about 30-60 minutes to take effect.
• Talk to them: Children may forget about any preparation if in distress. Narrate the steps of the procedure to them as they happen and reassure them they are safe and receiving the poke to stay healthy, not for punishment.
• Explain using simple language: Use clear and simple language to explain what immunizations are and why they’re important. For younger children, keep it straightforward, like saying, “The doctor will give you a quick pinch to keep you from getting sick.” As children grow older, they may have more questions or fears, so provide more detailed information and address any misconceptions they might have. Always be honest and open, encouraging them to express their feelings and concerns.
• Role play at home: For younger kids (and toddlers), pretend play is a great tool – use toys and dolls to demonstrate the vaccination process, saying something like, “Let’s practice with Teddy, Teddy needs a shot to stay healthy.” Offer choices: Would you like to hold Teddy’s hand while he gets the shot or show him how to take some deep breaths. This helps your child feel more prepared and in control, practice strategies, helping to reduce anxiety and fear. Validate their feelings and concerns, emphasizing the positive aspects of the visit.
• Offer choices: Giving your child a sense of control can help reduce their anxiety. Offer simple, realistic choices such as where to sit, which arm to get the pinch in, what to use as distraction, or even what treat they might like to get after the appointment. When offering choices, be reasonable and do not offer many at once.
• Engage your child in deep breathing: Not only does deep breathing help alleviate anxiety, it eases some of the pain of the vaccine. Children can pretend they are smelling a flower and blowing out a birthday candle. You could also use or ask for bubbles or a pinwheel! Practicing this in advance at home will also help them prepare and engage in this technique successfully in the clinic.
• Provide positive reinforcement: During and after the procedure, encourage and validate your child for what they are doing or did well. This reinforces positive behavior like selecting choices, remaining still, breathing, or staying distracted for future success!
• Remain calm: Most importantly, sometimes the best resource for a child during their most stressful moments is a calm parent. Children are incredibly perceptive to their caregivers emotions and voice.

Courageous and Calm: Navigating Teen Immunizations Together

• Involve Them in the Process: Let teens know about the upcoming immunization well in advance. Discuss the importance of vaccines and allow them to ask questions.
• Address Concerns: Teens may have more complex concerns, such as fear of needles or skepticism about vaccines. Validate their feelings and provide factual information to ease their concerns.
• Respect Their Autonomy: Encourage teens to take ownership of their health decisions by involving them in the conversation about vaccines. Offer choices where possible, such as scheduling options, where to
  receive the vaccination on their body, how to distract themselves or cope during the procedure, whether they want the parent in the room or not.
• Explain the Benefits: Emphasize how vaccines protect not just them, but also their friends, family, and community. Highlight the role of vaccines in maintaining their overall health and allowing them to
  participate in school activities or travel.
• Stay Calm and Supportive: Teens may pick up on your anxiety, so remain calm and supportive. Reassure them that it’s okay to feel nervous, but the experience will be quick and is crucial for their health.
• Distraction Techniques: Encourage your teen to bring something to distract them during the appointment, like listening to music or holding a stress ball.
• Ask About Numbing Cream: If the teen would like this option, inquire about it ahead of time from the healthcare team or request it upon check-in. Topical anesthetics such as EMLATM, AMETOPTM, and Maxilene may be available for purchase from pharmacies without a
  prescription. Apply it early, as it needs about 30-60 minutes to take effect.
• Follow Up: After the immunization, check in with your teen about how they’re feeling. Offer praise for their bravery and discuss any mild side effects they might experience.
• Reinforce the Positive: Highlight the fact that they are taking a responsible step in protecting their health. Reinforcing the positive aspects can help them feel more empowered about their health choices.

Overcoming Vaccination Stress & Needle Phobia : Support for Kids & Teens at Milika Center for Therapy & Resilience

As a parent, it can be heartbreaking to see your child struggle with anxiety, stress, or fear related to vaccinations or needles. You want to help them feel more confident and secure, but may not know where to turn. That’s where Milika Center for Therapy & Resilience comes in! Our team of expert psychologists and child-life specialists support children and teens in overcoming vaccination stress, needle phobia, and other challenges. By seeking help at Milika Center, you’ll be giving your child the tools they need to:

• Manage stress and anxiety
• Build resilience and confidence
• Develop coping skills for vaccination and medical procedures
• Succeed in academics and social life
• Don’t let vaccination stress or needle phobia hold your child back.

Contact Milika Center today for a free 20-minute consultation and take the first step towards helping your child thrive! Remember, with the right support, your child can overcome their fears and reach their full potential!