Fear of needles

This page explains about fear of needles and what to expect when your child comes to Great Ormond Street Hospital (GOSH).

No one really likes having a procedure that involves a needle, but it can be more of a problem for some. Fear of needles can affect anyone at any age for various reasons.

Some people develop this fear as a result of a previous bad experience, for example it taking more than one attempt to find a vein. Others may have seen or read about injections or having blood tests and may have not fully understood what happens. It can also develop if negative feelings are picked up from someone else, such as a friend, brother or sister, or parent.

Although fear of needles can be worrying for parents, particularly if your child needs regular injections or blood tests, there are ways to improve the situation.

All of the ideas here have come from our play specialists, who between them have years of experience of preparing children for hospital, tests, operations and procedures. If you have any ideas of your own or particular activities that work with your child, please contact us to tell us about them.

Think about previous experience

Before the appointment or admission, think about how your child reacted last time when an injection or blood test was needed.

If there were problems, remember what happened: was the room noisy, did you have time to talk to your child about it beforehand, and was local anaesthetic cream or spray used.

If your child was scared, try to remember which aspects worried your child the most as this can vary from child to child.

Understanding how your child reacted last time means that you can give us valuable information to reduce the fear this time.

Understanding

Ask yourself whether your child understands what is involved in the procedure. Some children pick up wrong ideas about what is involved, which can scare them even more.

Telling your child exactly what happens may reduce his or her fear. For example, explain about the whole process of taking a blood test, perhaps using a teddy or doll as the ‘patient’. You could put a dab of cream on teddy’s hand to explain the anaesthetic cream, use a ribbon as a tourniquet and talk about importance of keeping their hand and arm still. Using children’s doctors kits with ‘pretend syringes’ may also be beneficial.

You know your child best so tailor the information to his or her needs and level of understanding, but make sure that it is truthful.

When you tell your child also depends on his or her level of understanding. Younger children may not understand the concept of ‘time’ so wait until just before the procedure and be careful not to use words which will increase your child’s fear. For instance, many of us say there will just be a small sting but if a child has experienced being stung, this word can make them worry and refuse treatment.

With younger children it is important to reassure them that you will be with them whilst they are having the procedure.

If your child sees you are worried they too will worry and become scared. For more ideas about when and how to prepare your child, see our helping your child cope information.

Choices

There are going to be times when there either are no options around injections or blood tests or there is no time to offer them.

On most occasions, there will be a choice and it can help to involve your child in them, so talk to us to see what is possible. For instance whether to have the procedure sitting up, laying down or on a parent’s lap.

In situations where choices regarding timing of a procedure cannot be offered or are limited, discuss what to do after the procedure with your child. These don’t have to be expensive, a trip to the park, or to the shop to buy a drink would all help in letting your child feel they have had some choice and also have something nice to focus on while the procedure is taking place.

Pain relief

We routinely offer pain relief to children having an injection/blood test, either as a local anaesthetic cream or a spray. They both work by numbing the surface of the skin so the needle does not hurt as much when it is inserted, although your child may still feel the needle going in.

The main difference between them is the length of time they take to work and how long they last. Cream takes up to an hour to work but lasts for several hours, but the spray works immediately but also wears off after a few seconds.

Some children are told that the cream is ‘magic’ so they will not be able to feel anything. This is not entirely true, so we suggest that you say that they might feel some pressure but it will not hurt. For more information about sprays and cream, please talk to your nurse and read our information on topical anaesthetics.

Permission to cry

Facing a fear of needles is one situation where ‘being brave’ is not helpful.

We do not mind children shouting or crying during a procedure, although it helps if you warn us beforehand. Offering and encouraging your child the opportunity to sing rather than cry can sometimes work as an alternative.

It is important that your child realises that it is alright to make a noise. For most procedures, we will need your child to keep fairly still but shouting or crying is still fine. You could talk about it with the person doing the procedure so that you all know what noise to expect and even join in if you want. Doing this makes the situation more normal and therefore less frightening.

Comforting

Unless you have a great fear of needles yourself, it will help us if you can be with your child while it is happening. Sitting close enough to your child to hug or hold hands will give a lot of comforting and encouragement.

Younger children are often happier to sit on a parent’s lap because it is a ‘safe’ place. If you would prefer not to stay for the procedure, please bring a friend or relative with you so someone can sit with your child and comfort him or her.

Distraction

This is used a great deal by our play specialists during procedures, and you probably do it a lot each day yourself. The idea behind distraction therapy is that by taking a child’s mind off the procedure, the pain and fear associated with it will reduce.

Any activity that takes a child’s mind away from what is happening is worth trying, for instance, reading a book together, counting, watching a DVD or playing I SPY. You could try something a bit noisier, such as singing songs, or playing with a noisy toy. You might have to try different things to find out which works best for your child. For more suggestions about distraction, please talk to your play specialist.

Afterwards

Remembering which aspects worked and which did not help can be helpful in planning for the future. If they did not help, it might be helpful to talk it over with your play specialist. He or she will have lots more ideas than are mentioned here, and can even arrange for specific activities to reduce your child’s fear before the next procedure. It is important to deal with your child’s fear of needles so that it does not affect him or her so much in the future.

Last reviewed by Great Ormond Street Hospital: August 2010

Compiled by: 
The Play Service in collaboration with the Child and Family Information Group This information does not constitute health or medical advice and will not necessarily reflect treatment at other hospitals.
Last review date: 
August 2010
Ref: 
10F0884

Disclaimer

Please note this is a generic GOSH information sheet. If you have specific questions about how this relates to your child, please ask your doctor. Please note this information may not necessarily reflect treatment at other hospitals.