Nobody likes getting injections and a fear of needles and painful procedures in children is normal. Thankfully needle phobia is uncommon and an inappropriate term for the normal distress and anxiety experienced by children and young people when they have needle procedures. Fear is a normal response to a threat, (in this case, needle insertion), that involves three response systems, physiological arousal, covert feelings and thoughts and overt behavioural expressions. A phobia is considered to be an unreasonable response to unharmful stimuli. Clearly needles are harmful in that they physically hurt, so your child responding with fear is normal.

Helping your child cope:

It is helpful for parents to take as active a role as possible in supporting and encouraging their child through the needle insertion.

• Stay calm and supportive but firm and matter of fact.
• Try to involve your child even in small ways.
• Allow your child to have some choice where possible, e.g. which parent to sit with, or which arm to use (if possible). This will give them some sense of control.
• It is helpful to permit your child to be upset and not expect them to “be brave”.
• Distraction – encourage your child to focus on something which will absorb his attention during the procedure
• Slow breathing – teach your child to breath in deeply and blow out the scary feelings.
• Afterwards always acknowledge and reward your child’s efforts to comply with the needle procedure, even if it doesn’t go particularly well.

While it is common for children to be afraid of needles, most will adjust and learn to cope with needles in their lives. If you or your child develop difficulties coping with needle procedures, it may be helpful to have a consultation with your medical teams’ paediatric psychologist in order to develop an individualised age appropriate coping plan for your child. This may help prevent difficulties in the long term.

Paediatric psychologists will tailor the approach recommended to your child’s age. With younger children they may use and recommend medical play and distraction , while with older children and teenagers they often use cognitive-behavioural therapy (CBT) interventions. These are a group of procedures aimed at identifying unhelpful thoughts, attitudes and problem behaviour.

The key idea in CBT is the idea that challenging our negative thinking can be helpful. Thoughts affect feelings and if we change our thoughts we may be able to change our feelings. CBT has been found to be helpful when used in combination with progressive muscle relaxation training, guided imagery and distraction. These approaches has been found effective in reducing stress related to needle-related procedural pain.