Needle pokes: Reducing pain in children aged 18 months or over

Your child might need a needle poke to receive a vaccine, have blood work or receive fluids intravenously (through an IV) during a hospital visit. All these procedures are important for protecting or helping to treat your child, but they can cause pain. This can be stressful for both children and parents.

You can use a number of methods to help reduce the pain and anxiety associated with needle pokes. These include numbing cream, distractions and comfort positions.

Planning ahead

Talk to your doctor

Discuss your plan to ease your child's pain with your child’s healthcare team so they can support you.

Talk to your child

If your child is aged four years or older, talk to them about the needle poke ahead of time in language they can easily understand.

• Tell your child what is going to happen, for example, “The doctor is going to use a needle to give you a vaccine in your arm."
• Explain why your child needs the needle poke, for instance, “The vaccine will protect you from getting sick."
• Describe how the needle poke will feel, for example, “It might feel like a little pinch."
• Say what will be done to manage your child’s pain, for instance, "We’ll play a game so you don’t notice the needle poke much."

Before the needle poke

Numbing cream

You can help reduce the pain of needle pokes by applying a topical anaesthetic (numbing cream or gel) to the area where your child will receive their vaccine. In Canada, numbing creams are available over the counter.

• Discuss this option with your child’s team in advance.
• Make sure your child is not allergic to any ingredients in the numbing cream or gel.
• Apply the numbing cream or gel 30 to 60 minutes before the needle poke, according to the specific product's instructions. Once it is applied, the cream lasts up to three hours.

Distract your child

Use items such as favourite toys, mobile devices or bubbles to help distract your child during needle pokes. You can also sing, talk or tell jokes to distract them from any pain they might be experiencing.

Your healthcare team can also offer you items from a comfort kit to help distract your child. Ask your healthcare provider about the kit before your appointment.

During the needle poke

Hold your child

Holding your child comfortably in your lap helps to calm them during their needle pokes and encourages them to stay still.

Rub your child's skin

Rub your child's arm before, during and after the needle poke. As you rub an area of the arm away from the injection site, the feeling of touch from your hand competes with the pain your child experiences from the needle. This will help reduce your child's perception of pain.

Stay calm

If you are feeling anxious before and during your child’s needle poke, your child is likely to pick up on it and feel anxious themselves. Even though you may be nervous about the procedure, try your best to remain calm. Use your normal speaking voice and take slow, deep breaths.

For more detailed information on these suggestions, especially for vaccinations, please download the fact sheet Reduce the pain of vaccination in children under 3 years or Pain Management During Immunizations for Kids and Adolescents

Further information

​For more information about the Comfort Promise bundle of options to reduce the pain of needle pokes, please see the following pages:

Needle pokes: Reducing pain in infants aged up to 18 months

Pain relief: Comfort kit

Needle pokes: Reducing pain with numbing cream

Needle pokes: Reducing pain with sucrose or breastfeeding

Needle pokes: Reducing pain with comfort positions and distraction