Say goodbye to needle stick anxiety

Tips and tricks parents can use to help their child

Whether it’s an immunization, blood draw, or an IV, the idea of a needle stick typically produces anxiety. Parents want to shield children from the pain, but helping children to navigate through the process builds confidence and coping skills that they will need as they grow.

At the Children’s Hospital at Dartmouth-Hitchcock (CHaD), we reduce needle stick pain and anxiety through the Helping Achieve Positive Poke Experiences (HAPPE) program developed at CHaD by Holly Gaspar.

HAPPE brings caregivers, patients and providers together to determine an approach to diminish—and often, eliminate—needle stick anxiety. HAPPE is rooted in open communication and making all pain management options available to all children.

These strategies can be used alone or together to reduce needle stick pain and anxiety.

Medication.   Numbing cream is available by prescription and can be applied 15 to 40 minutes before a needle stick depending on the brand. Use a half-dollar amount above the inside of the elbow for blood draws, and wherever needles are expected. Cover the cream with plastic wrap until the needle stick. If you are uncertain about the best place to apply it, please ask.  Topical anesthetic misting sprays can also be used.

Babies often benefit from pacifiers dipped in sucrose, like Sweet-ease®. The sugar helps mask pain.

Distraction.   Nursing babies during and/or after needle sticks is encouraged. If a mother is uncomfortable nursing in front of medical staff, Sweet-ease is an alternative.

Two tools that go “between the brain and the pain” are Buzzy® and ShotBlocker®. Buzzy (a bee or ladybug device the size of a computer mouse) uses cold “wings” and vibration to stop pain sensations. ShotBlocker creates enough sensory information for children to confuse the pain with the feeling of the bumps on the tool.

Kids also love to play. Play I Spy, listen to a story, sing a song, count, play on a mobile app or look at books during needle sticks.

Positioning.   The use of comfort positioning allows children to feel cuddled while the providers have access to a nursing baby’s legs, hips and arm; older children can sit in-between the parent’s legs on their lap. They can sit back to belly, or belly to belly, with the parent’s arms over the child’s. This feels like a bear hug and delivers comfort.

Older kids get anxious, too.   Often, children 12 and older haven’t experienced needles regularly since early childhood. Breaking down the visit beforehand helps. Also, discussing strategies like closing their eyes, deep breathing or listening to music during the needle stick will alleviate stress. Talk about the experience afterward to help build coping skills.

Provide Smooth Transitions.   Having a good transition plan is important. This could include picking out bandages and stickers, visiting a play area in the hospital or pediatrician’s office, or going out for ice cream after the visit.

As CHaD’s Child Life Manager, Jessica Laperle supports the developmental, psychological and social needs of CHaD’s patients. She works to ensure a bridge between the playful child and the high-tech medical science of the hospital. She may be reached at

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