BRINGING a baby to the GP for a vaccination is a prospect that fills many parents with dread.
While the 10 vaccinations infants receive at the doctor’s over the course of the first 13 months of their lives undoubtedly protect their little ones against potentially life-threatening infections, mums and dads can still feel guilty about the pain (fleeting, but pain nonetheless) experienced by their offspring during immunisation.
However, take heart. While going for a jab is probably never going to be something anticipated with relish, experts maintain there is a lot that healthcare providers and parents can do to make the experience as stress-free and easy as possible, for babies, and for older children and adolescents, who receive their vaccinations at school.
According to psychologist and lecturer at the School of Psychology at NUI Galway, Line Caes, guidelines developed in Canada, which were updated just last year and which have been adopted by the World Health Organisation, outline a variety of ways of reducing pain during vaccination.
“If you have a combination of vaccinations, you can make the procedure as easy as possible by giving the most painful one first and the least painful after that,” said Caes.
“For babies, what has been proven to be very successful in reducing pain and stress during vaccinations is breastfeeding. It really reduces stress through a variety of mechanisms. It’s quite physically comforting, but it’s also distracting and, at the same time, the milk is quite sweet tasting, which has some effect on reducing pain.”
Skin-to-skin contact is also very helpful with babies, she says.
“If the mum or dad has an open shirt and they put the child, in a diaper, on their bare chest that’s very relaxing and stress-reducing for the child.
“The main psychological techniques you would use for four- to five-year-olds and adolescents are age-appropriate distractions and relaxation.
“Distraction can be playing a game on an iPhone, reading a book or watching a movie. It can even just be listening to music on headsets.
“Relaxation would be being able to take one deep breath or a few deep breaths of belly-breathing before the vaccination. For the younger children, for whom it might be difficult to take a deep breath, we recommend letting them blow bubbles.”
Meanwhile, the HSE’s National Immunisation Office advises parents to hold and comfort infants and young children during and after vaccination, while a favourite book, toy, or blanket can be given to them to use as a comfort.
“Breastfeeding during and after the vaccination has also been shown as a soothing measure for infants,” says a spokeswoman.
“Several studies have also shown that when children aged one or younger are given a few drops to half a teaspoon of a 24%-30% sugary solution (one teaspoon of sugar dissolved in four teaspoons of boiled water) just before an injection, they cry less.”
With four- to five-year-olds, the HSE recommends parents “are honest with their child before vaccination”, and explain that the vaccine will make them stay healthy, but might “pinch a little”.
During vaccination, which should be performed in a warm room, the child should be “held safely, embraced comfortably, and sitting up,” says the spokeswoman.
“The health professional can distract the child and make them feel at ease by talking and smiling, or pointing out interesting things... and the child can be asked to blow away the ‘pinch’ they might feel when they get the vaccine,” she says.
“Rubbing or stroking the skin close to the injection site before and during injection may help reduce pain for children aged four and older.
“After vaccination, children should always be reassured and praised for being brave.”
Meanwhile, she says it’s important that teenagers are informed about what the vaccine is for and the procedure involved.
“As with young children, it is important to make teenagers feel at ease, by reassuring them all the time.”
Teenagers who have fainted in the past should inform the health professional, as teens are more likely to faint after vaccination injection.
“For children or teenagers with needle phobia (including those with special needs), an anaesthetic cream can be applied before the vaccination, which numbs the feeling of the needle going through the skin.”
Those who are fearful of needles are best vaccinated in the privacy of a clinic room where they can be supported by a parent or friend.
Spokesman for the Irish College of General Practitioners (ICGP), Dr Mark Murphy, says that while babies receive two injections, “it’s very quick”.
“There might be a brief cry from the child, but usually that’s it.”
Dr Murphy says parents can make the process easier by dressing the child so their legs are accessible, while also ensuring they have lots of time.
“They should give themselves ideally an hour… If they are rushed, they might get more stressed and the child might sense that and become more anxious.
“Then everyone needs to stay calm.”
Psychologist Line Caes suggests the following steps to prepare your child for vaccination:
1 Babies: Begin breastfeeding or skin-to-skin contact two to three minutes before the vaccination.
2. Young children: Talk to your child in advance so they are prepared. Explain they are having a vaccination and that it’s important to stay healthy.
Let them have some control. Tell them they can take something to distract themselves and let them choose what that is, ie: a book, a toy. Don’t say it won’t hurt because a needle hurts a little bit.
3. Adolescents: Talk to them in advance and be open with them If they verbalise a fear of needles say it’s OK to be fearful — most people don’t like needles.