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'This Is Not Rocket Science': A Doctor's Mission to Overcome Children's Fear of Needles

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A mother with a baby on her lap sits next to a 3-year-old, who is playing with a toy needle and an Elmo doll.
Julia Cramer sits with her two children — Maya, 3, and Lily, 6 months — at their home in Petaluma on Dec. 19, 2023. Maya administers a pretend shot to her Elmo doll that she often brings to the doctors' office. (Beth LaBerge/KQED)

Any new parent has been through it: The distress of seeing your child scream at the doctor’s office. The torture of having to hold them down as the clinician sticks them with one vaccine after another.

“The first shots he got, I probably cried more than he did,” said Remy Anthes, rocking her 6-month-old son, Dorian, in his stroller.

“The look in her eyes, it’s hard to take,” said Jill Lovitt of her infant daughter, Jenna, who recently received her vaccines. “Like, ‘What are you letting them do to me? Why?’”

Some kids remember that pain and internalize the fear. Like when Julia Cramer’s 3-year-old daughter, Maya, had her blood drawn for an allergy test in Petaluma.

“After that, she had a fear of blue gloves,” Cramer said. “I went to the grocery store, and she saw someone wearing blue gloves, stocking the vegetables, and she started freaking out and crying.”

Pediatricians see this all the time. Research suggests that children’s biggest source of pain in the health care system is needle pokes, including in kids who are being treated for serious illness. Especially in some lower- and moderate-income countries, many hospitals that treat pediatric cancer don’t use central lines or small catheters, so every time a child needs blood drawn or IV medications, they get poked.

Picture the medical student trying 17 times to find a vein.

“This is so bad that many children and many parents decide not to continue the treatment. Even here in the United States,” Dr. Stefan Friedrichsdorf, medical director of UCSF’s Stad Center for Pediatric Pain, told an audience during November’s End Well conference in Los Angeles.

The trauma follows kids: An estimated 25% of adults have a fear of needles that began in childhood. And roughly 16% of adults refuse flu vaccinations because of it.

A man with glasses and a stethoscope blows on a mini pinwheel
Dr. Stefan Friedrichsdorf, medical director of Stad Center for Pediatric Pain, demonstrates one of the distraction techniques he uses for children receiving shots at UCSF Benioff Children’s Hospital in San Francisco on Dec. 18, 2023. (Beth LaBerge/KQED)

Friedrichsdorf said he has a solution: the Ouchless Jab Challenge.

“We can pretty much promise to completely take away the pain and the anxiety caused by needles, vaccination, blood draws,” he said. “This is not rocket science.”

He outlines the series of simple steps clinicians and parents can follow:

  • Apply numbing cream — over-the-counter lidocaine — 30 minutes before a shot
  • Breastfeed babies or give them a pacifier dipped in sugar water to comfort them while getting a shot
  • Use distractions, like teddy bears, pinwheels, or bubbles, to divert attention away from the needle.
  • Don’t pin kids down. Parents should hold children in their laps instead.

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Friedrichsdorf is leading the rollout of these new protocols this year at UCSF Benioff Children’s Hospitals in San Francisco and Oakland after launching a similar effort in Minnesota. Parents will have to take a leading role in demanding these measures at other local medical centers, he said, because the tolerance and acceptance of children’s pain is so entrenched among clinicians.

“We are taught to see pain as an unfortunate but inevitable side effect of good treatment,” said Dr. Diane Meier, a palliative care specialist at Mount Sinai in New York. “We learn to repress that feeling of distress at the pain we are causing because otherwise we can’t do our jobs.”

During her medical training, Meier had to hold kids down for procedures, a task she hated. It drove her away from pediatrics. She went into geriatrics instead and later helped lead the modern movement to promote palliative care in medicine, which didn’t become an accredited specialty in the U.S. until 2006.

Meier thinks the campaign to eliminate needle pain and anxiety should be applied to everyone.

“Just like in children and infants, people with dementia have no idea why human beings are approaching them to stick needles in them,” she said.

Friedrichsdorf’s techniques would likely work in this population, too, Meier said. Numbing cream, distraction, something sweet in the mouth, and perhaps music from the patient’s youth that they remember and can sing along to would all be helpful.

“It’s worthy of study, and it’s worthy of serious attention,” she said.

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