No-one likes injecting children and it’s always a challenge making sure they have adequate information that they and their caregivers understand. Children present in a wide range of maturity levels, and consequently with a wide range of needs and tolerances. Injecting moving targets is never easy. And to make it even harder, once they get past the age of about two, they start to realise what you’re about to do to them. So, here are some personal top tips for dealing with these lovely, but challenging, little customers.
1. Be on time and be concise
Kids are generally not great at waiting. Anticipation builds quickly in children and if it’s linked with anxiety about their upcoming injections then by the time they are in your clinic things can be very tough. Also, not unlike myself, they can start to get mischievous if bored and that’s when even more trouble happens; fingerprints all over the display cabinets, paintings on the wall, amended posters, noise, broken stuff, GDPR breaches when they mess with the computer…
2. Have some entertainment in the waiting room
This can avoid the problems noted in tip one. But remember, due to infection risks and health and safety regulations make sure your cleaning schedule incorporates any toys or books.
3. Support and encourage breastfeeding while injecting children
In the context of medical procedures, Breastfeeding has a strong evidence base for providing effective comfort before, during and after injections (or indeed most stressful activities)1. Some companies have ‘breastfeeding friendly’ posters around to help mothers to feel more comfortable to unleash this powerful tool. Think about how your practice can support breastfeeding during consultations in general.
4. Prepare the parents
Give good clear instructions for supporting the child while injecting them. If you have to demonstrate by getting your colleague next door to sit on your lap then do it. Enjoy the bonding, and tolerate the pins and needles. The Green Book has some recommendations (and pictures) for holding children safely, worth checking out. The videos below demonstrate the cuddle and straddle methods respectively.
5. Make the injections as ‘fun’ as you can
One parent I met called it ‘spikey medicine’ which almost made it sound fun… Involve children by asking them to hold equipment for you (like the plaster). Or see if they want to ‘inject’ their teddy bear or caregiver with a (needle-less) syringe.
6. Ask the right questions!
Start the consultation by asking the guardian of the child two key questions: ‘what does the child already know about the purpose of being there?’ And: ‘how do you want to do this?’ There is a lot of differing opinion regarding the morals and merits of distraction / not telling the child / sneaking up / negotiating / restraint / informed consent and so on. I suggest you are prepared to adapt as required and go intuitively with regards to how comfortable you feel about those things. I personally like to simply follow the parents lead when it comes to how honest, and forthcoming or sneaky I am (within reason).
7. Children often don’t like listening to two grown-ups talking about grown-up stuff, especially if it’s about injections
If you have the space and two caregivers aim to keep the youngster outside until the last possible minute before injecting the child. This way it’s less boring and stressful for them, and less distracting for you.
8. Stickers solve almost everything
Like these free flu stickers for instance. (They work for adults too!)
9. Consider if there are other family members being vaccinated simultaneously.
In most cases from personal experience, it seems to scare young children more if they have seen their parent or sibling get an injection before them. However, in some cases it helps to watch, especially if they are witnessing a positive non-dramatic encounter. In my experience the latter is a minority, and mainly works best with older children, so if you can arrange for them to go first or separately this might help. Again, be guided by the past experiences and preferences reported by the parent or caregiver. The age and maturity of the child will also have an influence here too.
10. Very important! Don’t forget to pay special attention to general and child specific health promotion behaviours that are related to the purpose of the injection too
In an effort to ‘get it over with’ quickly it can be easy to miss out vital information about aftercare, animal bites, water safety, or sun protection in a travel health consultation for instance – all very important, particularly for this vulnerable group. Think about the best time to give this information. Afterwards? Beforehand? A separate appointment? Or give the information in writing to take away? Travel health pro has an excellent factsheet on travel with children for instance which addresses way more than just the ‘travel jabs’.
Anyway, a bonus tip is don’t feel bad about having to give injections to children. Vaccines are one of the best preventative medicines we have ever had, and it will almost certainly save a lot more potential suffering than it causes. Always keep that in mind when times are tough!
Want to hear more top tips?
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- Harrison D, Reszel J, Bueno M, Sampson M, Shah VS, Taddio A, Larocque C, Turner L. Breastfeeding for procedural pain in infants beyond the neonatal period. Cochrane Database of Systematic Reviews 2016, Issue 10. Art. No.: CD011248. DOI: 10.1002/14651858.CD011248.pub2. ↩︎
