Currently browsing shots for kids posts

BUZZY – Because We ALL Need Shots That Don’t Hurt!

As a pediatrician, I strongly support vaccination. I never thought shots were a big deal; parents and staff even chuckle sometimes when a kid is freaking out about shots. You know, ‘deal with it’. I have taken care of children who died from vaccine-preventable diseases, and I used to think that any delay in shots endangers all society. Then I had my own kids, and witnessed firsthand that while vaccines don’t hurt children, shots do. Like most of the 22% of adults who fear needles, my son Max developed a phobia after a horrible shot experience at age 4. This fear affected him every time he had to go to the doctor. I gradually realized that if I didn’t act he could go through adulthood avoiding medical care.

It makes sense that being held down and subjected to more than five shots at a time could have a lifelong impact on complying with health care. When I tried to use numbing creams, one nurse said “that stuff doesn’t work, they need to get used to it”, and gave the shot outside the numb zone! I got mad at the system and myself. If I couldn’t protect my child and I’m part of the system, what parent could? I wanted to come up with something that worked instantly that parents and patients with established needle phobia could bring and use even if the healthcare system wasn’t interested.

I knew that the body could stop pain naturally using something called “gate theory”. If you bang your knee and rub it the pain stops, if you smash your finger and shake it, it helps the pain, or if you burn your finger and stick it under cold running water it quits hurting. I thought of cuffs of cold water, all sorts of messy stuff. Driving home from the hospital one day it occurred to me that vibration would block pain, but it wasn’t until my husband suggested frozen peas UNDER the vibration that it really made my kids’ hands numb to sharp pokes. And Buzzy was conceived.

Buzzy® uses natural pain relief by confusing your body’s own nerves and distracting attention away from the poke, thereby dulling or eliminating sharp pain. Over the past 5 years my children helped test, build, and prototype Buzzy until we had a device that worked. They smashed cell phones, helped me use electric tape and elastic bands, and have served as my first and best advisors. We started with a hand held massager and frozen peas, and finally got to a cute bee with frozen wings.

From a scientific standpoint, I didn’t want to put it out there unless I knew it worked for other people as well as my kids. The Mayday Fund, a nonprofit dedicated to the reduction of pain and suffering, sponsored Georgia State to do a research study in adult volunteers getting IVs inserted. Buzzy significantly decreased pain, and was more effective the more anxiety people already had. A trial in children needing IV starts in the emergency department also showed significantly decreased pain by child and parent report, and even increased IV success threefold. On the basis of this, we got a $1M grant from the National Institutes of Health to study whether Buzzy reduces the pain of immunizations, and hopefully can avoid the development of needle phobia.

How important is this?? Although needle pain from a shot may not seem like a big deal, needle sticks are the most common and most feared cause of medical pain in the world. Blood donation, preventative health care, and diagnosing serious illnesses like cancer are all impacted by fearing doctors and needles. Conversely, awareness and use of available pain control methods for children can result in years of improved health. Buzzy® is now being used for dentistry, travel immunizations, fertility shots, and finger pricks, splinter removal, and flu injections! We’ve heard from parents who had considered stopping more effective injected or IV treatments due to needle fear who are now able to give their kids the best treatment due to Buzzy. We’ve even heard from kids… stories and letters that remind us that Needle Pain Matters…and because of that, so does Buzzy.

HEALTHFUL HINTS:

Before a shot:

My area of research is pain control, so I hear a lot of stories about drama at the doctor’s. For young children, pain is punishment and scary, so addressing fear is an important first step to making shots less of a big deal. Children are less fearful when they know what’s happening and feel in control. Sadly, there are no global answers, but there are some general tricks of the trade you can try.

  • When asked “am I going to get a shot?” focus on the benefit. “Yes, they have medicine that keeps you healthy.”
  • NEVER promise they won’t get a shot unless you intend to follow through and come back another time if they’re due for one
  • NEVER threaten with a shot if children don’t behave (establishing a needle as punishment or you as untrustworthy will guarantee a bad experience).
  • If the child’s question is, “Is it going to hurt?”, avoid using the words pain or hurt. Instead, use the word “bother”, and answer this way: “Actually, a lot of kids aren’t that bothered by shots. Before you get them, I’ll show you how we will make getting them not a big deal.”
  • If they’ve had a bad experience in the past, say “I found out about some new cool things we can do to make them much more comfortable.”

And now – the shot:

  • First, relieving kids’ distress begins with you. The best combination is warm but firm. No apologizing, empathizing, or letting them “just go to the bathroom real quick.” Instead, use praise, “I know you can do this”, and direct them to pay attention to non-shot related things before they get anxious. “Oh, look, SpongeBob.”
  • Second, the person giving the shots. These are research-proven things that make shots hurt less:
    • Give the least painful shot first
    • Give the shots sitting up in the arm after age 18 months
    • Use a slower push
    • Use a longer needle
    • Use “position of comfort”: facing you on your lap, or with your arm around the child if they are older and receiving shots sitting up. Being held flat is the most vulnerable positing you can be in; much better if 4-6 year olds can straddle your lap facing you and get shots while you hug them.
  • Third, to help overcome established needle-phobia:
    • There are creams (over the counter LMX-4, Ferndale Labs) which can be applied 20 minutes in advance, or prescription EMLA (Astra-Zeneca) which needs at least an hour. Be sure they’re placed correctly, and know that they only numb the surface. Never promise complete pain relief. Instead, try “these will help a LOT!”
    • Studies show that appropriate distraction decreases distress. While the nurse is getting the injections, let a child choose from multiple visual games or tasks to focus elsewhere during the shot. “Do you want me to read to you, or give you things to find?” Be prepared to pick if they’re indecisive. “You know what I think would be good? Let’s do this…” Bee-Stractors Emergency Entertainment cards can be kept in a purse or glove compartment for situations when you forget to plan ahead.
    • Tasks that include a sensation also help focus attention away from the poke: for example, tell your child to count zigzags as you scratch the edge of a fingernail on their arm. Tell the child to yell “now!” when a fingernail gets to the elbow or wrist. For multiple shots or a seriously anxious child, bring an ice pack or vibrating toy to touch other body parts and have the child name the body part touched by ice. “Knee! Leg! Nose!” Even better, touch them with an ice pop and 5 right answers wins the pop!
    • And speaking of ice packs, studies have shown that putting an ice cube on the site before a shot can decrease the pain. Adding an element of vibration during the poke can help as well, like when a dentist wiggles your lip during Novocaine. This is the breakthrough of Buzzy, but you can achieve the same results with any vibration/solid ice pack combination. For best results, let the child feel the sensations beforehand by scratching the arm under the ice pack/vibration source. “See how cold this is, and see how now you can’t feel so much any more?” Seeing for themselves and agreeing with you helps the child feel in control.

Whatever happens, praise how they did!

**************************************************************************************************************

Editor’s Note: With the increased transmissibility of the Delta variant, COVID-19 cases are on the rise around the United States as well as the rest of the world. And though there is currently no approved vaccine for kids under 12, there is still a tremendous role that Buzzy can play! Over half of adults unvaccinated for COVID-19 fear needles. To no-one’s surprise, this same fear affects how willing teens and adults are to get vaccinated. The good news is you don’t have to be a child for Buzzy to help. Although we first ran this post in 2011, what Dr. Baxter has to say is as true today as it was then. Shots hurt…and they shouldn’t…and with Buzzy, they don’t have to.

Please – if you haven’t already – for your sake and the sake of your family
Get vaccinated for COVID!

Study: Shots “More Upsetting” for Babies of First-time Mothers

Last updated on April 26th, 2018 at 02:54 pm

baby-shots-and-first-time-mothers“Babies with anxious mothers ‘feel more pain’ during jabs (*shots),” is a headline in The Daily Telegraph.

The story comes from a study looking at whether a baby’s “pain behaviours” (such as crying and tensing their limbs) during their first immunisation is affected by their mother’s mental health or if she is a first-time mother.

Despite The Telegraph’s headline, the study did not show any direct association between maternal anxiety (at least, long-term pre-existing anxiety disorder) and infant distress.

It did show that the babies of first-time mothers expressed more “pain behaviours” both before and during the first vaccination than the babies of mothers who have other children.

The researchers speculated that a first-time mother’s unfamiliarity with the vaccination process may be picked up by the baby in some way and this causes short-term psychological distress, making them more vulnerable to pain.

The good news for worried mums is that the study also found that all mothers consistently overestimated their baby’s pain levels during vaccination – in other words, it did not hurt their baby as much as they thought it did.

And, of course, a quick prick of the skin is nothing compared with the pain associated with preventable conditions such as measles or mumps.

Based on these findings, the researchers have advised that first-time parents be better prepared for infant vaccinations and given more information about the procedure and how the shots will affect their kids.

Read NHS Choices’ Six practical vaccination tips for parents.

Where did the story come from?

The study was carried out by researchers from the University of Durham. There is no information about external funding.

The study was published in the peer-reviewed Journal of Reproductive and Infant Psychology.

The Telegraph’s headline claiming that babies with anxious mothers feel more pain during jabs was misleading, depending on how you want to define the term “anxious mother”.

The study found that babies of first-time mothers expressed more distress before vaccination, and the authors suggest this may be caused by heightened levels of maternal anxiety immediately before and during the vaccination process.

But no link was found between increased levels of distress and whether the mother had mental health issues, such as anxiety disorder, depression or problems coping with stress.

The research was covered fairly, although uncritically, by the Daily Mail and The Telegraph.

However, again it is probably misleading to talk about the babies “feeling more pain”, as both papers did.

The study looked at behavioural signs of distress in the babies and not directly at their pain levels.

Any increase in signs of distress could mainly have been related to psychological, not physical, discomfort.

What kind of research was this?

This was a prospective observational study looking at whether a mother’s mental health and if she was a first-time mother had any association with how much distress babies express during their first routine vaccinations at two months of age.

The study also looked at whether the baby’s distress was associated with how often they were touched by the mother.

This type of study can only show an association – it cannot show, for example, that a mother’s anxiety levels cause her baby to feel more pain.

In this type of study there may be many other factors (called confounders) that affect a baby’s expression of distress during vaccination.

The authors point out that vaccinations are a common cause of pain and distress in babies and that early experiences of pain shape an infant’s response to later painful events. Maternal levels of stress and depression have previously been found to have a link with infant expression of pain, and research has also indicated that being a first-time mother may be linked to this, but the evidence is still limited.

What did the research involve?

The authors initially recruited 66 mothers and their babies who were attending baby clinics.

All the babies had been assessed as healthy by health visitors, who saw them before the vaccination procedure. Sixteen of the mothers were excluded from the final analysis for various reasons – for example, 13 babies were held during the vaccination by another relative or friend rather than the mother.

Nineteen of the remaining women were first-time mothers.

The mothers and babies were all videotaped during the first routine immunisation at two months of age, which involves two vaccinations.

The researchers measured infant pain levels during the vaccination procedure using a behavioural assessment which looked at levels of crying, facial expression and pain movements (for example, tensing, clenching limbs and flailing).

These behaviours were taped using a HD digital film camera and were studied frame by frame. A composite total pain measure was then calculated. The final infant pain score varied from 0% (no pain behaviours) to 100% (all pain behaviours all of the time).

They also measured and coded maternal touching behaviour such as rubbing, patting, kissing or rocking.

The recordings were studied frame by frame in order to assess the amount of pain babies expressed in the following five phases during the immunisation process:

  • 20 seconds before the first vaccination
  • During the first vaccination – where the needle entered the skin
  • The time between the two vaccinations
  • The second vaccination
  • 20 seconds after the second needle had been removed

After the vaccination, mothers completed a validated questionnaire which assessed stress immediately after vaccination, and a further questionnaire to assess whether they were depressed.

Researchers used a pain questionnaire to assess how mothers evaluated their babies’ pain on a scale of 0 (no perceived pain) to 10 (maximum perceived pain).

They analysed their results using standard statistical methods.

What were the basic results?

Forty-nine mothers completed the study, with an average age of 29 years:

  • 23 were stressed
  • 7 were depressed
  • 1 was both stressed and depressed

The researchers found that:

  • Babies of first-time mothers showed significantly more pain behaviours before the insertion of the first needle and during the first vaccination than the babies of more experienced mothers
  • Maternal mental health, stress levels and type of touch had no association with infant pain expression
  • All mothers consistently overestimated their babies’ pain levels and their assessments were “poorly correlated” with infant pain behavior

How did the researchers interpret the results?

The researchers say the findings suggest that being a first-time mother may influence infant pain expression before and during the first vaccination, independent of maternal mental health. They suggest that further research, possibly looking at interventions for new parents, is needed.

Conclusion

This is a small study and although it was carefully carried out, its findings should be viewed with caution. As the authors point out, its size means it may not have had the power to detect all differences in infant pain expression. They argue that a larger study incorporating a more balanced sample of mothers and including other racial and ethnic groups is needed. In addition, other factors could have affected how the babies reacted, including their particular mood at the time.

Still, it seems likely that first-time mothers may find their child’s first immunisation more difficult and their feelings may be sensed by their babies. It would seem to be helpful if this group was given full information about what happens during immunisation to prepare them for the event ahead of time.

If you are a first-time parent, NHS Choices articles you may find useful include:

Analysis by Bazian. Edited by NHS Choices. Follow Behind the Headlines on Twitter.

Summary

“Babies with anxious mothers ‘feel more pain’ during jabs,” was today’s headline in The Daily Telegraph. The story comes from a study looking at whether a baby’s “pain behaviours”…

Links to Headlines

Links to Science

Editor’s Note: *clarification provided for our US readers.

NHS Choices logo


From www.nhs.uk

A Parent’s Guide to Childhood Immunizations – Part II

Last updated on April 26th, 2018 at 03:00 pm

I will pick up where I left off in A Parent’s Guide to Childhood Immunizations – Part I and deal with some immunizations not yet mentioned (and I do apologize for the time lapse between these posts).

Baby girl gets vaccinatedMMR (Measles, Mumps and Rubella [German Measles]) is a very good, effective vaccine used for many years without significant problems, regardless of the negative information that has appeared over the years to attempt to link this vaccine with a number of problems. The supposed link between this vaccine and the development of certain neurologic disorders (e.g. autism) originated in an article appearing over 15 years ago in a British medical journal. Multiple attempts to prove this information have shown no relationship as mentioned above. Not only was this a very poorly designed study but the very same journal was forced to retract the article and in fact the author was stripped of his license to practice medicine and severely punished. There have never been articles since then confirming the supposed association.

Measles is a highly contagious viral illness that has been responsible for wiping out entire populations of primitive and un-immunized people. As with the other 2 diseases in this combination of vaccines in MMR, there can be very serious complications that can lead to prolonged and serious illnesses and even death. Combining these three vaccines into one has been shown to be both safe and highly effective. The side effects of the vaccine are mild and temporary.

Mumps is also highly contagious and can as with German Measles cause significant serious problems.

Varicella (Chicken Pox) has a preventative vaccine with few side effects and very good protective capability. The disease has the potential to cause serious illness and may necessitate hospitalization. As with the vaccines mentioned so far, the low incidence of any problems is way less than contracting the disease.

Hepatitis A is an infectious disease of the liver (as with Hepatitis b mentioned in Part I) but is actually easier to contract than B and far more common. While Hepatitis B needs contact with blood or body fluids to possibly contract the disease, Hepatitis A also can be contracted through contact with stool, urine and saliva- all very prevalent in day care an nursery settings. The vaccine is one of the very best that we have- very small incidence of very mild side effects, and very high degree of protection bordering on 90 to 95% in some studies.

Pneumococcus, (similar to the hib mentioned in Part I), is a bacteria that can cause serious disease in all ages. In the past, there were a large number of deaths associated with contracting illness due to this bacteria- fortunately since the vaccine (pneumococcal) was introduced, this incidence has greatly diminished.

Just a few more vaccines:

Meningococcal disease is responsible for death and/or disability in a large number of those contracting this disease. It’s degree of infectivity rises to higher levels where there are large numbers of young people congregated such as in dormitories and therefore the vaccine is recommended as children get older and are preparing for college, or other situations of group activities (overnight camp, etc.)

HPV (Human Papilloma Virus) is an infectious disease transmitted through sexual activity and therefore the vaccine is recommended as children are entering puberty or before. While this vaccine was initially directed at girls, it has become apparent that because this is a disease transmitted between the sexes, it is equally important to vaccinate boys also at about the same age.

Now that you are aware of the vaccines and the illnesses they protect against, and the safety and efficacy information, I hope you will have your child fully immunized when recommended by his/her Pediatrician. (Click here for the American Academy of Pediatrics 2016 Immunization Schedule). I have been practicing Pediatrics for almost 40 years and have had the unfortunate opportunity to see first-hand the ravages of some of these illnesses before immunizations were available to prevent them. I then was overjoyed to watch the dramatic decrease in these deadly diseases after the introduction of appropriate vaccines. Research is always ongoing and I look forward with great anticipation to the further eradication of diseases that affect children worldwide.

If there are any other questions regarding immunizations or shots, please communicate these to me.

DistrACTION Cards: Because Kids Already Know Shots Hurt

Last updated on June 10th, 2016 at 07:16 am

robotcardsAs a pediatrician, I have a confession to make. I’m ashamed to admit that in residency I was amused when kids ramped up the drama getting shots. I’m not talking about a sadistic pleasure watching a 4 year old get poked repeatedly, I’m talking about an artistic appreciation of the wailing, screaming, and ninja-like thrashing performance when the nurse brought in the tray and….cleaned the child’s arm. With cotton. Gently. Yep, it was hard not to restrain a snicker when you alerted the child that, far from being near death from pain, the procedure hadn’t started yet. See? Cotton.

As a pain researcher, I now know that fear dramatically increases pain perception. Not only that, but focusing on the site where you expect pain naturally enhances your body’s perception of pain. Just like focusing on bite of gourmet food enhances your perception of nuances of the flavor (“Oh, cilantro!”) focusing on a painful procedure enhances that pain to occupy your entire consciousness. Not great if you don’t want pain.

Pain relief has become a major focus of medical professionals and children’s hospitals in recent years. While topical anesthetics have been around for decades, only 7% of pediatricians use methods to decrease the pain of needles. Recent innovations to address pediatric pain have been introduced, in part due to the realization that needle fear has jumped from 25% to 63% of children. Needle Phobia slide2This 252% increase is theorized to result in part because there are five times more live-saving vaccines that are now routine, and the realization that some vaccines need to be given at older ages to work well. Older age means kids remember the event, have greater cognitive powers to focus on the event, and thus can develop ongoing issues with needles when they experience vaccines as traumatic..

One physiologic way to deal with pain has been spotlighted here before, putting the cold and vibration unit Buzzy “between the brain and the pain”. The body feels sensations of cold and massage, and has less bandwidth to perceive pain. The sensation can even be disrupted, just like cold running water eliminated the pain of a burned finger. What I realized soon after developing Buzzy, however, was that a kid who is bound and determined to let you know how much they hate shots can feel pain from an alcohol swab. For a highly anxious kid who hasn’t seen Buzzy before, the explanation of “how this is going to make it better” might even focus them more on the procedure. I realized I needed something to help the child who is already afraid…something to decrease the fear AND take the focus off the poke.

Fortunately, kids have amazing imaginations, and — Ooh, look at that! —are pretty easy to distract. An easier, faster, and less expensive way to address pain and even boredom comes from the delightful curiosity kids have about new things, especially when they’re brightly colored. The very trait in kids that can be frustrating in long lines or car trips can actually be a huge advantage in managing pain. In fact, some of the more traditional hospital distractions (blowing up a balloon, etc.) had been proven to decrease children’s distress with medical procedures consistently by about 50%… But for this situation – for the child walking in terrified – we needed something more…but what? And thus, the DistrACTION cards were born….

Pain Fear and FocusWhat we’d learned was that controlling pain wasn’t enough for anyone – Fear, Focus on the procedure, and Pain all contribute to the experience.

To optimally pull a child’s attention away from a painful procedure, Child Life therapists use a variety of techniques, from blowing out (pinwheels, balloons, deep breathing) to visual distractions, both passive (videos) and active (Where’s Waldo??). Pulling from the distraction pain literature, I distilled the elements that seemed to be most helpful. In a stressful situation, too much difficulty (math problems) can be counterproductive. This is why “Where’s Waldo”, while a good active distraction, is actually less effective for most medical situations: he’s just too hard to find. The concept, though, is useful – visual active tasks like finding work well. Adding rote elements like counting can be good, but it depends on how hard it is to find something. “How many of something can you find” can be too easy if they’re right there – you could stop after one. “Find 6 of something”, however, is a concrete task which adds visual input to the cognitive task and gives the comfort of rote familiarity. The trick is distracting effectively for the right situation, giving just the right amount of challenge with the comforting ritual of counting. It’s that simple.

purple cowDistrACTION cards have 10 questions on the back of each one, stratified by age groups.

They include questions that require simple finding for younger kids (Where is a purple cow?) with some questions that only adults could get (Can you find all the suits in a deck of cards?) Classic counting, how many cows?, was found to be too easy for older kids, so questions add difficulty by asking “How many cows are wearing a costume?”)

After creating the DistrACTION® Cards for medical procedures, investigators around the world started testing them.

  1. First, Buzzy plus Distraction was tested for IV access in Turkey. Used correctly, Buzzy Bees on hospital bed during IVdecreases needle pain 50-80%, and has been highlighted in Phlebotomy Today as a way to help draw blood in anxious patients. When DistrACTION is added, both together reduce pain from IV insertion 88%.
  2. Investigators then started evaluating the DistrACTION cards alone. In the first study, pain was reduced 50% with the “Monkeys” set of cards alone; even cooler, 97% of kids said the procedure was better than previous times they’d had blood drawn.
  3. Subsequent studies comparing other Child Life techniques found that DistrACTION cards decreased pain more than playing with a kaleidoscope; another study found the cards more effective than blowing a balloon, or playing a singing cartoon game.

The DistrACTION cards have now been clinically proven in three studies to be even better than other distractors in hospitals

Beyond pain management though, we found a terrific secondary benefit. When you can distract a child well enough to reduce pain in an unfamiliar environment, adding DistrACTION cBoredom busterards to a situation that is “merely boring” is extremely effective. From a 2 hour junior high concert recital to (one emergency nurse admitted) sitting through Mass, the cards have been extremely helpful for everyday behavior support. They’re waterproof, so they even work on the beach. No batteries, no screens – who knew?

I think the coolest thing for me has been that now, I get amused when a child seems very anxious, starts to ramp up the drama… and then is told “It’s already done!” As kids learn how distraction helps them deal with their own pain, the lesson sticks, even when there are no cards around. At a recent doctor visit for HPV vaccination, my older son said “Wait! You don’t have DistrACTION cards? Ok, ok, no problem…” he looked around the room and found red, blue and yellow speckles on the tile floor.” “No problem. When I need the shot, I’m counting confetti!” When he didn’t even flinch with the poke he was almost as proud of himself as I was!

HEALTHFUL HINTS

  1. Distraction is an extremely effective parenting technique for multiple situations quite apart from pain management. Trouble starts brewing when children get bored, but a child who learns how to entertain themselves will have that skill their whole lives.
    • It’s critical to not depend on a battery powered source for distraction – whether it’s a small book, Distraction cards, or a small pot of play-dough, props help avert a boredom-induced meltdown. Once you learn the level of difficulty that keeps a kid engaged, the world around becomes a perfectly good distraction. “OK, I spy with my little eye…”
    • YOU are the best distraction for your child. While older kids can ask each other questions or read the questions on the back of the cards themselves, human interaction keeps a distraction interesting.
  2. For injections and medical procedures, there’s a difference between offering distraction and forcing a kid not to watch. Let the 20% of kids who prefer to view the procedure do so – it may be it’s own distraction for them, or a way for them to feel in control of the situation so they’re less afraid.

A Parent’s Guide to Childhood Immunizations – Part I

Last updated on April 26th, 2018 at 03:03 pm

Baby girl gets vaccinatedImmunizations against a multitude of illnesses are begun during infancy and continued into adolescence. While there are many immunizations given during this period many are combined with others so that the total number of actual “shots” are fewer than if given separately. Regardless of the number of immunizations given at one particular time, research has consistently shown that there are no greater side effects in both severity and number when these immunizations are given to your baby. Furthermore, the earlier these are given, the more protection is afforded your baby during a time at which these illnesses can have serious consequences. Research has shown the proper ages at which to give these shots to kids and these ages have become the standard. (Click here for the American Academy of Pediatrics 2015 Immunization Schedule)

DPT (diphtheria, pertussis and tetanus) is extremely important to protect your baby. Diphtheria is a devastating disease that mankind has had to deal with in the past that can swell the throat to the point of suffocation, along with high fever and a very ill child. Pertussis is still around today and is worse in severity the younger the child; there is severe prolonged coughing with a characteristic “whoop” at the end of a spasm as the child “catches his/her breath”. Many people with a persistent cough can be carrying Pertussis. There is also high fever and fatigue and loss of the natural cough suppression of the brain to the point of lack of oxygen. Tetanus is a severe disease and often ends with the death of the patient- muscle spasm especially of the facial muscles, fever and exhaustion also is present and again the younger the child the worse the symptoms and outcome.

Hib is a vaccine against a bacteria called Hemophilus Influenza type b, and can be responsible for illness in children and adults. It used to be a main cause of meningitis (another severe illness consisting of inflammation of the covering of the brain and spinal cord. Fortunately after the vaccine was appoved and used, there has been a marked decline in that particular kind of meningitis. Another triumph of man over bacteria.

IPV or OPV (polio) is an illness that sometimes caused muscle weakness to the point of suffocation. “Iron lung” (a certain type of respirator) used to be needed to help people breathe but the rate of death was still high. The polio virus is still around today but the disease is either mild or without symptoms at all.

Hepatitis b can be a very debilitating disease that can permanently injure the liver leading to lifelong problems and shortened life span. This is given in a series of three and has very few to no side effects.

There are still many immunizations to cover that I will do in a follow up early next Spring

The bottom line is that it is important to fully immunize your children at the earliest possible and allowable time. Listen to your doctor, he/she is fully aware of benefits of these life saving vaccines.

Buzzy – Because Kids Need Shots That Don’t Hurt

Last updated on August 31st, 2015 at 12:42 am

Buzzy eases the painAs a pediatrician, I strongly support vaccination. I never thought shots were a big deal; parents and staff even chuckle sometimes when a kid is freaking out about shots. You know, ‘deal with it’. I have taken care of children who died from vaccine-preventable diseases, and I used to think that any delay in shots endangers all society. Then I had my own kids, and witnessed firsthand that while vaccines don’t hurt children, shots do. Like most of the 22% of adults who fear needles, my son Max developed a phobia after a horrible shot experience at age 4. This fear affected him every time he had to go to the doctor. I gradually realized that if I didn’t act he could go through adulthood avoiding medical care.

It makes sense that being held down and subjected to more than five shots at a time could have a lifelong impact on complying with health care. When I tried to use numbing creams, one nurse said “that stuff doesn’t work, they need to get used to it”, and gave the shot outside the numb zone! I got mad at the system and myself. If I couldn’t protect my child and I’m part of the system, what parent could? I wanted to come up with something that worked instantly that parents and patients with established needle fear could bring and use even if the healthcare system wasn’t interested.

I knew that the body could stop pain naturally using something called “gate theory”. If you bang your knee and rub it the pain stops, if you smash your finger and shake it, it helps the pain, or if you burn your finger and stick it under cold running water it quits hurting. I thought of cuffs of cold water, all sorts of messy stuff. Driving home from the hospital one day it occurred to me that vibration would block pain, but it wasn’t until my husband suggested frozen peas UNDER the vibration that it really made my kids’ hands numb to sharp pokes. And Buzzy was conceived.

Buzzy® uses natural pain relief by confusing your body’s own nerves and distracting attention away from the poke, thereby dulling or eliminating sharp pain. Over the past 5 years my children helped test, build, and prototype Buzzy until we had a device that worked. They smashed cell phones, helped me use electric tape and elastic bands, and have served as my first and best advisors. We started with a hand held massager and frozen peas, and finally got to a cute bee with frozen wings.

From a scientific standpoint, I didn’t want to put it out there unless I knew it worked for other people as well as my kids. The Mayday Fund, a nonprofit dedicated to the reduction of pain and suffering, sponsored Georgia State to do a research study in adult volunteers getting IVs inserted. Buzzy significantly decreased pain, and was more effective the more anxiety people already had. A trial in children needing IV starts in the emergency department also showed significantly decreased pain by child and parent report, and even increased IV success threefold. On the basis of this, we got a $1M grant from the National Institutes of Health to study whether Buzzy reduces the pain of immunizations, and hopefully can avoid the development of needle phobia.

How important is this?? Although needle pain from a shot may not seem like a big deal, needle sticks are the most common and most feared cause of medical pain in the world. Blood donation, preventative health care, and diagnosing serious illnesses like cancer are all impacted by fearing doctors and needles. Conversely, awareness and use of available pain control methods for children can result in years of improved health. Buzzy® is now being used for dentistry, travel immunizations, fertility shots, and finger pricks, splinter removal, and flu injections!

We’ve heard from parents who had considered stopping more effective injected or IV treatments due to needle fear who are now able to give their kids the best treatment due to Buzzy. We’ve even heard from kids… stories and letters that remind us that Needle Pain Matters…and because of that, so does Buzzy.

HEALTHFUL HINTS:

Before a shot:

My area of research is pain control, so I hear a lot of stories about drama at the doctor’s. For young children, pain is punishment and scary, so addressing fear is an important first step to making shots less of a big deal. Children are less fearful when they know what’s happening and feel in control. Sadly, there are no global answers, but there are some general tricks of the trade you can try.

  • When asked “am I going to get a shot?” focus on the benefit. “Yes, they have medicine that keeps you healthy.”
  • NEVER promise they won’t get a shot unless you intend to follow through and come back another time if they’re due for one
  • NEVER threaten with a shot if children don’t behave (establishing a needle as punishment or you as untrustworthy will guarantee a bad experience).
  • If the child’s question is, “Is it going to hurt?”, avoid using the words pain or hurt. Instead, use the word “bother”, and answer this way: “Actually, a lot of kids aren’t that bothered by shots. Before you get them, I’ll show you how we will make getting them not a big deal.”
  • If they’ve had a bad experience in the past, say “I found out about some new cool things we can do to make them much more comfortable.”

And now – the shot:

  • First, relieving kids’ distress begins with you. The best combination is warm but firm. No apologizing, empathizing, or letting them “just go to the bathroom real quick.” Instead, use praise, “I know you can do this”, and direct them to pay attention to non-shot related things before they get anxious. “Oh, look, SpongeBob.”
  • Second, the person giving the shots. These are research-proven things that make shots hurt less:
    • Give the least painful shot first
    • Give the shots sitting up in the arm after age 18 months
    • Use a slower push
    • Use a longer needle
    • Use “position of comfort”: facing you on your lap, or with your arm around the child if they are older and receiving shots sitting up. Being held flat is the most vulnerable positing you can be in; much better if 4-6 year olds can straddle your lap facing you and get shots while you hug them.
  • Third, to help overcome established needle-phobia:
    • There are creams (over the counter LMX-4, Ferndale Labs) which can be applied 20 minutes in advance, or prescription EMLA (Astra-Zeneca) which needs at least an hour. Be sure they’re placed correctly, and know that they only numb the surface. Never promise complete pain relief. Instead, try “these will help a LOT!”
    • Studies show that appropriate distraction decreases distress. While the nurse is getting the injections, let a child choose from multiple visual games or tasks to focus elsewhere during the shot. “Do you want me to read to you, or give you things to find?” Be prepared to pick if they’re indecisive. “You know what I think would be good? Let’s do this…” Bee-Stractors Emergency Entertainment cards can be kept in a purse or glove compartment for situations when you forget to plan ahead.
    • Tasks that include a sensation also help focus attention away from the poke: for example, tell your child to count zigzags as you scratch the edge of a fingernail on their arm. Tell the child to yell “now!” when a fingernail gets to the elbow or wrist. For multiple shots or a seriously anxious child, bring an ice pack or vibrating toy to touch other body parts and have the child name the body part touched by ice. “Knee! Leg! Nose!” Even better, touch them with an ice pop and 5 right answers wins the pop!
    • And speaking of ice packs, studies have shown that putting an ice cube on the site before a shot can decrease the pain. Adding an element of vibration during the poke can help as well, like when a dentist wiggles your lip during Novocaine. This is the breakthrough of Buzzy, but you can achieve the same results with any vibration/solid ice pack combination. For best results, let the child feel the sensations beforehand by scratching the arm under the ice pack/vibration source. “See how cold this is, and see how now you can’t feel so much any more?” Seeing for themselves and agreeing with you helps the child feel in control.

Whatever happens, praise how they did!

**************************************************************************************************************

Editor’s Note: Flu season is upon us – and The Old Farmer’s Almanac predicts that this winter will be another arctic blast with above-normal snowfall throughout much of the nation. So what comes to mind? ..stock up on chicken soup …and warm blankets …and get your flu shot. And that made us think of Dr. Amy Baxter and her amazing invention: Buzzy. Because even though we first ran this post in 2011, what she has to say is as true today as it was then. Shots hurt…and they shouldn’t…and with Buzzy, they don’t have to. Enjoy!

Next Page »