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Pain Management

Vaccinations are a routine part of medical care. The pain caused by vaccinations can be upsetting for children, teens and adults who may avoid vaccinations, leaving them without protection from serious disease. Here are some tips on how you can take the pain out of vaccination.

These methods are proven to be safe and effective. You can combine the different methods for better results. Tell your child's family physician, paediatrician, or nurse what you plan to do so they can support your goals.

What you can do

Breastfeed your baby

  • If you are breastfeeding, start to breastfeed your baby before the needle. Make sure you have a good latch. Then continue breastfeeding during and after the needle.
  • Breastfeeding combines holding, sweet taste, and sucking and is one of the best ways to reduce pain in babies.
  • Breastfeeding during needles is safe for babies, even for newborns. There is no evidence that babies will choke or associate their mothers with pain.

Hold your Child

  • Position your child upright and hold your child close before, during and after the needle. This helps your child to feel secure and to stay still.

What you can give

Sugar Water

  • Breastfeeding is important for infants. If your baby is not breastfeeding, you can use sugar water to reduce your baby's pain.
  • Sugar water is safe for babies, even newborns.
  • Make sugar water at home or at the clinic by mixing 1 teaspoon of white sugar with 2 teaspoons of distilled water or boiled water. For babies over 6 months, you may use tap water if the tap water is safe for drinking.
  • Give your baby some sugar water 1 or 2 minutes before the needle using a dropper (or syringe).

Topical anaesthetic cream, gel or patch

  • In Canada, you can buy topical anaesthetics to reduce the pain from needles without a prescription: EMLA™ (lidocaine-prilocaine), Ametop™ (tetracaine), or Maxilene™ (lidocaine).
  • Sugar water is safe for babies, even newborns.
  • Make sugar water at home or at the clinic by mixing 1 teaspoon of white sugar with 2 teaspoons of distilled water or boiled water. For babies over 6 months, you may use tap water if the tap water is safe for drinking.

How you can act

Your state of mind

  • Try to stay calm, use your normal speaking voice, and be positive before, during and after the needle; this will help your child stay calm.
  • Children see and feel what their parents are doing, and often do the same.
  • If you are nervous, you can take a few slow, deep breaths to calm yourself.
  • Breathe so your belly expands, not your chest. You can do this while holding your child.

Distract your child

  • Taking your child's focus away from the pain can reduce your child's pain.
  • While holding your child close, distract with singing or talking. For babies, breastfeeding is ideal for sucking. A soother may be used with or without sugar water, if you are not breastfeeding. This can be done before, during and after the needle. Add rocking your child back and forth after the needle.
  • You may choose to distract an older child with toys such as bubbles, pop-up books, rattles, or smartphones. If toys do not work, hold your child close and distract with singing or talking. Allow baby to suck (breastfeeding or soother) before, during and after the needle. Add rocking your child back and forth after the needle.

Videos

Children under 3 years

These methods are proven to be safe and effective. You can combine the different methods for better results. Tell your child's family physician, paediatrician, or nurse what you plan to do so they can support your goals.

What you can give

Topical anaesthetic cream, gel or patch

  • In Canada, you can buy topical anaesthetics to reduce the pain from needles without a prescription: EMLA™ (lidocaine-prilocaine), Ametop™ (tetracaine), or Maxilene™ (lidocaine).
  • They are safe in children.
  • Apply them at home or at the clinic before the needle.

What you can do

Upright positioning

  • Have your child sit upright before, during and after the needle.
  • Your child may be held on your lap; this helps your child to feel secure and to stay still.
  • Make sure you undress your child to free the arm(s) where the needle will be given.
  • Don't hold your child too tightly. If you do, this can increase your child's distress.

How you can act

Your state of mind

  • Stay with your child, be calm and use your normal speaking voice during and after the needle.
  • Acknowledge your child's pain but don't focus on it.
  • This will help your child stay calm.
  • Children see and feel what their parents are doing, and often do the same. If you are nervous, you can take a few slow, deep breaths to calm yourself before, during and after the needle.
  • Breathe so your belly expands, not your chest.
  • Direct your child to take slow deep breaths before, during and after the needle.

Distract your child

  • Taking your child's focus away from the needle can reduce your child's pain.
  • Distract with singing, talking, counting, jokes, books, bubbles, pinwheels, toys, or electronic devices like smartphones and computers before, during, and after the needle.
  • For best results, choose a distraction that involves multiple senses (sight, touch, and hearing) and have your child actively participate.
  • Keep your child's attention on the distraction.
  • Be prepared to change what you are doing to keep your child distracted.
  • There are a few children that cope better if they watch the needle, so if your child says they want to watch, that's ok too.

Videos

Kids and Teens

These methods are proven to be safe and effective. You can combine the different methods for better results. Tell your child's family physician, paediatrician, or nurse what you plan to do so they can support your goals.

What you can use

Topical anaesthetic cream, gel or patch

  • Use creams, gels or patches to numb the skin where the vaccine will be injected.
  • In Canada, you can buy topical anaesthetics to reduce the pain from needles without a prescription: EMLA™ (lidocaine-prilocaine), Ametop™ (tetracaine), or Maxilene™ (lidocaine).
  • Apply to your upper arm before immunization.
  • Ask your health care provider about correct placement of the product.
  • These products take 30-60 minutes to numb the skin. Your skin may temporarily appear lighter or redder than normal.

What you can do

Body position

  • Pick the most comfortable position for you.
  • Sit upright or lie down, whichever is the most relaxing for you.
  • Relax your arm. It may help to dangle your arm and then reposition it to ensure that your arm and muscle are completely relaxed.

How you can act

Stay calm

  • Take a few slow, deep breaths to calm yourself.
  • Breathe so your belly expands, not your chest. Breaths should be deep and then slowly exhaled.

Distraction

  • Take your attention away from the pain.
  • Use conversation, music, video, reading, pictures, smartphones, and/or simply look away.

For more information, visit the Breastfeeding Committee for Canada (BBC) and the Baby-Friendly Initiative Ontario (BFI)

Last updated: 17/12/2018

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