Distraction techniques can help calm children from shot-related anxiety during flu season

A typical visit to the pediatrician when it is time for a child to get a shot can include tears, tantrums and might not seem worth the trouble. But with the FluMist not being offered by many physicians this year due to ineffectiveness, doctors at Nationwide Children's Hospital recommend your child still get the flu shot. To calm shot-related anxiety, parents can ask their pediatrician about distraction techniques to help comfort their child when receiving a shot.

"The Centers for Disease Control and the American Academy of Pediatrics have issued recommendations against the FluMist this year," said Dennis Cunningham, MD, medical director for epidemiology and infection control at Nationwide Children's Hospital. "However, everyone 6 months and older should still get a flu vaccine injection unless they have medical reasons to avoid them. Vaccinations are the most effective way to protect against influenza, a very serious disease that affects the lungs and respiratory tract."

Evidence-based medicine has proven that developmentally appropriate support measures do help to reduce fear and procedure-related stress for children

"Adults should keep in mind that they often set the stage for how the child will cope," said Donna Trentel, MSA, CCLS, director of family and volunteer services at Nationwide Children's. "Kids of all ages naturally tune into the signals given by adults pay attention to your stress level, word choices, and cues you are sending your child."

Infants, for example, respond well to swaddling, pacifiers and breastfeeding for pain control. Younger children (2-6 years old) respond well to distractions like videos, music, singing and special positioning, opportunities for choice and control such as to watch or not watch, picking which arm is used, and having a role like holding the bandage. Older children (6 years and older) respond well to relaxation such as deep breathing, praise, and guided imagery, like imagining and talking about a favorite place.

"It's not uncommon for a child to feel anxious or scared when it's time to get a shot," said Melissa Winterhalter, MD, physician with the Section of Ambulatory Pediatrics at Nationwide Children's Hospital. "If a child is really upset, or crying, or anxious, we'll stop and really look for those distraction techniques to relax the child, to ease the pain so that it's a quick and easy process for both the child and the family."

One method Dr. Winterhalter's team has begun using for her patients is a friendly animal-shaped cold pack that also vibrates when placed on the injection site. The various sensations scramble the pain response that the body feels, so a child will feel the cold or the vibrations and not necessarily the pain from the injection. Tools such as this, along with other distractions, can help soothe a child and make the experience easier.

"Parents are the key to success," said Dr. Winterhalter. "If there is something that works well for your child, let your pediatrician know so they can implement that technique. Parents can also help by talking to their child openly and honestly about any procedure beforehand, so they understand what is happening and what to expect."