Helping your child with needle fear

Needle fear is the fear of a medical procedure in which a needle is used to puncture the skin. This could be for instance during a blood test, vaccination or when giving a medicine.

Although most people find these procedures unpleasant, needle fear is a term used to describe someone who is very frightened or resistant to having a procedure with a needle and has a lot of trouble getting over this. 

Some children may also suffer from a needle phobia, which is a more extreme condition – this may include fainting, sweating, nausea (feeling sick), pallor (looking pale), tinnitus (sound in the ears) and panic attacks. If your child is suffering from any of these symptoms then please seek help from your doctor as soon as possible.

If your child is prescribed growth hormone they will need a daily treatment. Growth hormone can be given by two methods, one with a needle and one needle free. Before you start treatment it is worth understanding the factors that may cause needle fear and how you can help to alleviate it, or whether you should speak to your doctor about delivery systems that avoid needles altogether.

Factors that can increase needle fear include: 

• Having a bad experience – perhaps having an experience where it was difficult to inject, or having someone who used the wrong technique.
• Feeling isolated - not being heard by the caregiver (either the parent, doctor or nurse) about their fear.
• Having a bad reaction – perhaps an allergic reaction to a medicine or vaccine that was given by injection. 
• Duration of treatment – longer treatment courses can lead to more chance of needle fear developing. 

Factors that can help with needle fear include: 

• Confidence – being comfortable with the caregiver e.g. the doctor, nurse or family member carrying out the procedure.  
• Understanding – having knowledge about why treatment with growth hormone is necessary.
• Involvement – being involved in the diagnosis and management of the growth disorder and its treatment.  

The cause of the needle fear varies from child to child. You know your child best, and will most likely be able to identify which factors are affecting your child. 

There are a variety of age-specific techniques to help your child overcome their needle fear, which are outlined below.

Preschool period (3 to 6 years old)

Preschoolers are very inquisitive and often use the question 'why?'. This natural curiosity can be used to your advantage, and you can use these questions as an opportunity to talk about your child’s growth disorder and treatment. 

Provide information in a simple way, using pictures, books or even videos where you can. Remember children of this age have a vivid imagination and can struggle to separate fantasy from reality. So be careful with how you explain things – for instance using gnomes as an example of short people can be confusing or even frightening.

Use as much real life based material as possible - for example rather than trying to explain about their medication, let your child touch and feel the medical device for themselves. This will help to dispel any fears.

The following suggestions can help your preschooler cope with the pain or anxiety during the injection:

• Ensure a comfortable position for both yourself and your child for the injection. 
• Distract and relax your child – the following may help:
  • Humor and jokes 
  • Soft music
  • Counting rhymes and reading books
  • Cuddles or close body contact
  • Using a bubble blower
  • Cuddling with their favourite toys
  • Singing songs together
  • Watching television or a film 
• Rewards – cuddle, praise or use treats to reward your child afterwards. 

You can also use role-playing here to help your child express fears around their treatment. This can involve using two toys – one to be your child and the other to be the parent. The toys can then play out a ‘story’ of having an injection. Your child may be able to explore their feelings using their toy to say things they might otherwise not be able to.

School age children - (6-12 years)

Primary school children are constantly learning and becoming more responsible and independent. At the same time they also have a need for the safety and security of their parents, as well as a desire to belong to a ‘group’. Working with these different needs will help your child to adjust to their treatment. 

• Learning – you can now teach your child more about their treatment and their growth disorder in general. This will help them to feel more empowered about their condition and more involved in their treatment. 
• Independence - children at this age can help with certain parts of their treatment. This may be simple things such as collecting their medication from the pharmacy, getting it out ready for treatment or even cleaning their skin in readiness for the jab. 
• Security – young children still need lots of security from their parents and family unit. Having a confident and calm approach around your child’s growth disorder and treatment will help your child have a more positive outlook.  
• Belonging – as children become more aware of other children and belonging to a group, they will be more conscious of being 'different'. Emphasise that there are always differences between individuals and that everyone is unique.

The following suggestions can help your child in dealing with the pain during injection:

• Ensure a comfortable position for both yourself and your child for the injection. 
• Distract and relax your child – the following may help:
  • Humor and jokes 
  • Soft music
  • Counting rhymes and reading books
  • Cuddles or close body contact
  • Using a bubble blower
  • Cuddling with their favourite toys
  • Singing songs together
  • Watching television or a film 
  • Playing on a computer game (with one hand only)
• Calming exercises: 
  • Guided imagery – using a recording or your own voice 
  • Breathing exercises – teach your child relaxing techniques using their breath
• Rewards – cuddle, praise or use treats to reward your child afterwards. 

If, despite these techniques, your child is still very resistant to treatment and is afraid of the needle, speak to your doctor.

Remember that there are a variety of different delivery systems, including several needle free devices for growth hormone. Speak to your doctor about what options are available for your child.

Use the links below to find out more about:

• Symptoms and types of growth disorders.
• When to see your doctor and how to get diagnosed.
• How to treat growth disorders.
• How can we live with it - information and help with supporting your child, with stories from real life patients and a section on needle fear.