It is common for children to be fearful or anxious about needles, whether getting a vaccine, medication or having blood drawn. Luckily, there are many evidence-based strategies to help manage needle anxiety that your child may experience. 

Talking to your child before, during and after the appointment:

Talking to your child about needles can help decrease their needle anxiety and make future appointments a more positive experience. Here are some tips to consider:

• Talk to your child ahead of time. Surprising your child last minute with the needle appointment can make anxiety worse. Consider telling your child at least a few days in advance and talk about what you can do together to prepare for a smooth experience.
  • One tool to help you and your child prepare is the “My Blood Draw Plan” for children and youth, which can be used for all procedures that include needles.
• Use neutral language. Talking in a matter of fact, calm and supportive way can lessen anxiety.
  • If your child is worried that the needle will hurt, you could say, “Some people say they don’t feel much at all, and other say it feels like a pinch. Let’s find out what it’s like for you.”
  • If your child is getting a vaccine, you could say, “The vaccine can help you stay healthy. The medicine will be put in your arm with a needle. You will feel a quick poke.”
• Don’t apologize. Saying to your child things like “I’m really sorry you have to go through this” can make your child feel like something bad is happening and increase stress. Instead, you could say something like, “I understand that you are feeling nervous, that is okay. I’ll be right here with you”.
• Acknowledge your child’s efforts. Positive recognition after the needle can help your child feel good about the skills they learned during the appointment.

Strategies to help in the moment:

A good place to start is to walk through the CARD system (Comfort, Ask, Relax, Distract). You can also play the interactive CARD game with your child to help them get ready and have some activities on hand. CARD can help decrease stress-related reactions, improve the overall needle experience, and teach lifelong coping skills.

• Get comfortable. Being physically comfortable can help your child feel more at ease during the appointment.
  • have your child wear clothes that show the area of the body where the needle will go
  • if your child does not need to fast, offer your child a snack to eat ahead of time
  • encourage your child to bring a favourite item
  • give your child the option to sit up in a chair or lie down
  • ask your child to make their arm loose or jiggly, like cooked spaghetti

• Ask questions. Encourage your child to ask any questions they may have about the procedure. Understanding what is happening at the appointment can make them feel more prepared.
  • What will happen on my turn?
  • What vaccine or test am I getting?
  • Can I…
    • have the needle in a private room?
    • use numbing creams or topical anesthetics? (You may need to purchase and apply the numbing cream 30 to 60 minutes prior to your child’s appointment. Ask your pharmacist about numbing creams or topical anesthetics.)
    • look at the needle? or look away?
• Try to relax. When you are calm and use your normal voice, it helps your child feel like everything is okay. This can help your child be calmer and more relaxed.
  • practice calm breathing with your child (pretend to blow a bubble or blow out a candle)
  • encourage your child to give themselves some positive self-talk (for example: “I can do this!”)
  • hold your child’s hand or offer comfort in a way that works for your child
• Introduce a distraction. Having something else to focus on during the appointment can help your child in the moment.
  • talk to your child
  • let your child play a game or watch a video
  • bring a book or magazine to read to your child or have them read themselves
  • let your child choose music to listen to see if there is a song they want to sing
  • encourage your child to daydream about fun things, or think about a favourite memory

Consider putting together a care package with your child to bring to the appointment that includes some of the items listed above in the CARD examples, such as a snack, favourite item, and book. Having items that are familiar can increase your child’s comfort level.

After the needle work, take time to celebrate the victory, even if it didn’t all go to plan. This may include a reward to recognize your child’s bravery for doing something that was challenging for them. Consider giving your child a few options and letting them choose how they would like to celebrate.

Other resources:

• Check out these age-specific tips from Immunize BC on having a more positive vaccination experience:
  • For parents and caregivers of a younger child: https://immunizebc.ca/children/have-positive-experience/tips-infants-young-children
  • For parents and caregivers of an older child or youth: https://immunizebc.ca/children/have-positive-experience/tips-school-age-teens
• Watch this 2 minute video for tips and strategies for reducing distress and fear in young children getting a needle: It Doesn’t Have to Hurt

My child has needle phobia, what now?

5-10% of children have needle phobia, which is a high level of fear that makes getting a needle very difficult. Needle phobia can lead to trying to avoid needles or healthcare visits. This fear may need extra attention before your child can successfully have a procedure that includes a needle. Ask your child’s doctor, local hospital, or mental health services for healthcare providers who specialize in anxiety and exposure-based therapy. If your child is preparing for school vaccinations, consider talking to their teacher or school nurse ahead of time to see what option are available to support your child.

Even if your child doesn’t have a needle phobia, needle-related procedures may be challenging due to stimulating or busy environments. This may be the case for children who are neurodiverse or have neurodevelopmental challenges. When you book the appointment, ask whether there are any accommodations to make the needle experience more positive.

Blood work support programs in BC:

• Child Life Specialists at BC Children’s Hospital (BCCH) provide the Poke Practice Program to support children and youth with anxiety, developmental delays or autism to complete blood work. Note, this service is not available for vaccine support.
• Lifelabs has developed specific blood work practices as part of their Serving Customers with Autism program. This program was developed to deliver a safe and positive experience to increase the chance of success.