May 09, 2014
By Shereen Jegtvig
NEW YORK - Mothers-to-be who learned strategies to relieve vaccination pain were very likely to use them when it came time to have their baby vaccinated, according to a new Canadian study.
Parents who worry about the pain caused by needle sticks might choose to delay or avoid vaccinating their children, which could undermine immunization, the study authors warn.
Although techniques to relieve pain are available, the majority of infants don't receive them and parents don't know what to do to help, they said.
"We did a little survey: we asked parents what they were doing to manage pain during immunization," Anna Taddio told Reuters Health. "We asked physicians and we found that most kids were not getting the benefits of the analgesics that had been well proven to work."
Taddio, from The Hospital for Sick Children in Toronto and the Leslie Dan Faculty of Pharmacy at the University of Toronto, led the new study.
She said breastfeeding babies or giving them sugar water during the actual needle stick, using topical anesthetic creams on the injection site and holding babies and older children close can help relieve pain from shots.
The group Immunize Canada provides video guides on reducing vaccination pain for babies and kids, she noted, available here: http://bit.ly/1hxLK7K.
"Pain is not being treated," Taddio said. "This is not good for kids, not good quality of care, not good for parents and kids who are stressed during immunization, not good for healthcare workers, and then some kids have got needle fears."
About one in every four adults is afraid of needles, she noted.
"Most of the time the needle fears come when you are a kid and you had a bad experience with needles," she said.
Taddio and her colleagues wanted to find out if adding a 20-minute educational presentation to the regular prenatal program at Mount Sinai Hospital would increase the number of infants who received pain relief during vaccinations.
They enrolled expectant mothers and randomly assigned 96 of them to receive the pain education program and 101 to see a similar presentation on infant vaccines, but without mention of pain management techniques.
A follow-up questionnaire was used to determine if mothers employed pain relief methods during their child's two-month routine vaccinations.
Thirty-four percent of mothers who received the pain education program reported using one or more pain relief methods compared to 17% of those in the other group, according to the results published online April 7 in the journal Pain.
The researchers observed 32 vaccination appointments - 15 with women from the pain education group and 17 with those from the comparison group - and found women were accurately reporting their use of pain relief on the questionnaires.
Women in the pain education group also knew more about pain relief methods and were less satisfied with pain management interventions during their child's vaccinations.
The authors report that 12% of parents were blocked from using pain relief methods - usually breastfeeding - because the clinicians giving the vaccines didn't approve.
"This was an interesting study and it showed that some parents could take this and be empowered enough to actually implement it, so that is good - so there is some power in arming the parents," Taddio said.
"But the flip side is, of course we have to give them enough information so they really feel like they know how to do it and we did have some parents who tried some of this stuff they wanted to do but then the clinician who was going to give the vaccines had blocked them so that is the bad thing," she said.
"I think this is an interesting robust study - anything that improves the quality of the user experience is important, especially when the combination and numbers of immunizations given in national programs are increasing," Anne McGowan told Reuters Health in an email.
McGowan is a nurse consultant with the Vaccine Disease Prevention Programme for Public Health Wales in Cardiff, UK. She wasn't involved in the new research, but has studied ways to minimize vaccination pain in infants.
"It's concerning that about one in 10 mothers are put off breastfeeding during immunization because of disapproval and ignorance about infant choking," she said.
McGowan said the study reinforces the need to educate healthcare providers and parents in the management of pain during shots.
"Efforts need to be made to increase awareness about pain management and ensure that these evidence-based methods to reduce pain during immunization become part of routine care," she said.
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