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The question

My kids are really afraid of needles. They scream at the idea of going to the pediatrician for the flu shot. How do we deal with that?

The answer

The fear of needles usually appears in children around five years old. Medically, it is known as belonephoria, a condition in which 80 per cent of patients with this fear have a first degree relative with needle phobias.

This is a condition which is very real, and at times incapacitating. Some children faint upon seeing a needle. They may refuse vaccines and other critically needed lab tests.

Start by being supportive. Be a good role model yourself. Desensitization over time has been possible if done right (At times cognitive behavioral therapy by a trained psychologist is the only solution to getting over this phobia).

Do not lie by saying this will not hurt. Explain it does hurt - but only for a few seconds.

Distract the child by getting him or her to blow bubbles, sing, or use books or video games; allow him to squeeze your hand tightly.

Some places offer a service of using EMLA cream beforehand or a spray that anesthetizes the area where the needle will puncture the skin. Another alternative is to apply an ice pack beforehand in that area which decreases the pain.

Give the child something to look forward to: promise a visit to his or her favourite store after the doctor's office. This may provide an incentive to endure the discomfort.

Praise a child who tries hard — even if it does not always work. The effort at least is a start in the right direction, and over time, the child may learn that in the end all will work out well and that the discomfort is only temporary.

Send pediatrician Peter Nieman your questions at pediatrician@globeandmail.com. He will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.

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The content provided in The Globe and Mail's Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.

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