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 Needle Fears & Phobia

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 What is needle phobia?

Fear of needles is very common in children and adults. All children get needles as part of their regular immunizations. Those with illnesses may need them more often, for medications or blood tests. Most children and adults are able to handle their fear of needles, so they are able to get the immunizations, medications or blood tests they need.

But if the fear is so great that it stops someone from getting needles, then it may be a condition known as ‘needle phobia’. This can be a problem because avoiding needles because of fear can interfere with good health care. And because needles may also be needed for some jobs, health insurance, travel, or education, needle phobia could affect many areas of a person’s life.

How common is needle phobia?

Needle phobia is fairly common. Researchers believe that somewhere between 1 in 20 and 1 in 10 children and adults have needle phobia. (Craske, Antony, & Barlow, 1997; Kleinknecht, 1987; Mark, 1988).

What causes needle phobia?

Needle phobia probably happens from a few things going on at the same time: (Hamilton, 1995; Willemsen, 2002).

  • Family history. Many people with needle phobia have relatives with needle phobia.
  • Life events. People with needle phobias have often had a negative experience getting a needle (or close relative has had a negative experience). Needle phobias can also develop after seeing or hearing about the negative experience of others.

What happens during needle phobia?

When faced with a ‘needle situation’, those with needle phobia:

  • Feel intense fear and distress
  • Will have an increased heart rate and blood pressure (Willemsen, 2002).

After the heart rate and blood pressure increases, the body tries to slow things down a little. This reflex (vaso-vagal reflex) causes the heart to slow down and the blood pressure to drop. Sometimes this reflex is so strong that the person passes out or faints. (Willemsen, 2002).

Ways to handle the vaso-vagal reflex:

  • Make sure your child or teen is lying down when getting an injection, IV, or blood test
  • Have your child or teen stay lying down for a few minutes after the needle, and get up very slowly
  • Ask your child or teen to tighten the muscles in the arm, legs and body, while relaxing the needle arm.

What To Do About Simple Needle Fears

First, explain why a needle is needed. You might say, "this needle will stop you from getting sick this year". For younger children, you can show what will happen by pretending to give a needle to a doll or stuffed animal. If the needle can’t be postponed (for example, in the emergency department), stay with your child to offer support and comfort. Let your child know that it’s OK to cry.

Talk to your child about the needle phobia, and find out what bothers him most about getting a needle. You might say, "What is it about a needle that makes it so scary?" or "What stops you from being able to get a needle?" This makes it easier to help your child or teen cope. Your child or teen can help decide which coping strategy might work best.

For example, if your child is:

  • Afraid of losing control, you can work together to increase your child’s sense of control. You might ask:
    • "Do you want me (or someone else) with you when you have the needle?"
    • "Do you want to know what is happening or would you rather not?"
    • "Shall we make the appointment on Wednesday or Thursday? What should we have for lunch afterwards?"
  • Afraid of the pain, special skin numbing cream can be used (like the EMLA [eutectic mixture of local anesthetics]™ Patch) or cream. These can be used on healthy, unbroken skin before a needle or blood test. You can get these from most pharmacies; just follow the instructions in the package. You might also try placing an icepack to the skin for a few minutes before the needle.

Other ways to help a child or teen cope with getting a needle:

Reduce distress by taking children’s attention away from the needle by:

  • Playing a handheld video game
  • Listening to music
  • Playing with a noisy toy
  • Playing ‘I spy’ or another similar game
  • Closing their eyes really tight and facing the other way
  • Talking about a fun activity they’ve done recently

Focus on the positive

  • Praise your child or teen for positive coping
  • Notice little steps toward getting a needle, even if your child wasn’t able to follow through
  • Consider a treat after the needle, but be very clear about what you expect and what the treat will be ("you’ll need to sit still during the needle, but we’ll get ice cream after."

Be a model of calm

It’s easier for children and youth to be calm if you stay calm. If you are comfortable getting needles, invite your child to be with you the next time you need a blood test or needle.

Find a way to handle your own fears if you get tense and upset when your child gets a needle. Many parents of children with needle phobias may have needle phobias too. You may want to see a mental health professional to learn how to overcome your own fear.

Don't focus on the negative

Many adults with needle phobias talk about being teased, put down or shamed when they were younger because of their needle phobia. Getting angry or frustrated with your child won’t help. If your child or teen is not coping well, show that you understand her distress, and then say something encouraging. For example, "I know this is really hard for you. But we’ve put the numbing cream on, now let’s think about what made us laugh so hard during that movie…"

Make positive coping statements

Children or teens with needle phobia may be having anxious thoughts, like: "It’s going to hurt!" or "I can’t handle this!"

Help your child to come up with more helpful thoughts, like, "It really won’t hurt that much" or "It will be over in a few seconds!"

If you think your child or teen may have needle phobia…

Many children and youth dislike needles. But if it’s to the point where your child or teen is refusing to get a needle, you may want to think about seeing a professional to help your child.

Doctors and nurses can help with basic coping strategies. If these are not enough, ask your doctor to suggest another professional, like a psychologist. Psychologists often use the following approaches to help children and youth with needle phobia.

Approaches for helping needle phobia  

1. Exposure / Desensitization / Rehearsal
This involves step by step practice of getting a needle. It breaks down the process of getting a needle into smaller steps that may be easier to handle, one at a time.

For example:

Step 1: Looking at books or videos about getting a needle or going to the doctor’s office. Many children’s hospitals also have websites with this kind of information.

Step 2: For younger children, let them play ‘doctor’ or ‘nurse’ with a medical play set. They can practice giving pretend needles to each other or to dolls or stuffed animals.

With older children and teens, a therapist may use real needles, encouraging teens to:

  • Look at a needle
  • Hold the needle
  • Put a needle next to their skin, but without breaking the skin.

Practice with real needles isn’t used often and should only happen during treatment with a mental health professional.

Step 3: Going to the doctor’s office and just wait in the waiting room

Step 4: Go to the doctor’s office, wait in the waiting room, see the doctor, but without getting a needle.

Step 5: Go to the doctor’s office, wait in the waiting room, see the doctor, and get the needle.  

2. Relaxation training and breathing exercises

When we get nervous, we often start to breathe faster. Taking slow deep breaths can be very calming. Focusing on breathing can also help distract children and youth from thinking about the needle. Your child can also learn and practice ways to calm down and relax. Learn more about the MindMasters series developed at CHEO.

3. Imagery: Creating pictures in your head, like being in a soothing place, or being calm while getting a needle.

4. Hypnosis: A family doctor or psychologist trained in hypnosis can help children and youth to reach a deep, relaxing state (hypnotic state).

Finding help in Eastern Ontario

  • In a crisis? Child, Youth and Family Crisis Line for Eastern Ontario, 613-260-2360 or toll-free, 1-877-377-7775
  • Looking for mental health help? www.eMentalHealth.ca is a bilingual directory of mental health services and resources for Ottawa, Eastern Ontario and Canada.
  • Renfrew County: Phoenix Centre for Children, Youth and Families, with offices in Renfrew and Pembroke. 613-735-2374 or toll-free 1-800-465-1870, www.renc.igs.net/~phoenix
  • Leeds and Grenville County: Child and Youth Wellness Centre, with offices in Brockville, Elgin, Gananoque and Prescott. 613-498-4844, http://www.cywc.net/ 
  • Lanark County: Open Doors for Lanark Children and Youth, with offices in Carleton Place, Smiths Falls and Perth. 613-283-8260, http://www.opendoors.on.ca/
  • To find a Psychologist anywhere in Ontario: College of Psychologists of Ontario, 1-800-489-8388, http://www.cpo.on.ca/

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