Many pediatricians don't take kids' pain seriously - particularly when it comes to ear infections and sore throats, writes Dr. Ralph Berberich in Pediatrics.
Wendi Fellner always nursed her baby daughter when she got her childhood immunizations, and that baby has grown into a 9-year-old who’s pretty fearless about shots.
But Fellner, who lives in Winter Park, Fla., will never forget her first -- and last -- visit to the office of a new pediatrician she tried when her daughter was four months old.
The nurse told her it was against the practice’s policy to allow moms to breastfeed babies while they were getting shots. Infants could choke on breast milk if they started crying from the shot, don’t you know?
In fact, the nurse went on, it was against policy for parents even to touch infants who were getting immunized. Liability issues, you know, she told Fellner. What if the parent jumped when the baby screamed?
Policy-schmolicy, Fellner thought. She persuaded the reluctant nurse to bend both of the rules and then quickly found another doctor for her daughter’s next checkup.
Pediatrician Ralph Berberich, who practices in Berkeley, Calif., has heard too many stories like that. Frustrated, Berberich and Dr. Neil Schechter, a pain doctor at Children’s Hospital Boston, wrote an article entitled “Pediatric Office Pain: Crying for Attention,” that will be published next month in Pediatrics. The journal posted the piece online Monday.
Many doctors, and their office staffs, don’t take kids’ pain seriously, Berberich told msnbc.com. They view shots as a rite of childhood that prepares them for a lifetime of doctor-inflicted pain.
“They don’t know that the literature shows there are indeed lasting consequences,” Berberich says. One in 10 adults is phobic about needles, he notes, and you can bet that fear stems from a heavy-handed doctor in childhood.
Even less attention is paid to pain from sore throats and ear infections, Berberich says. “Doctors are very afraid to put medications in the hands of parents and trust that they will know how to use them.”
In 2009, Berberich reported in Pediatrics about a method to distract kids from shot pain. It involves a cooling spray on the site of the injection and a vibrating massager that meanders down the other arm.
When the massager reaches their elbow, children are told to say “elbow,” which makes them forget to say “ouch,” Berberich says.
While the method “is very successful,” it requires an extra nurse and perhaps a couple more minutes of time, he says. Ultimately, though, it saves time and money, because he doesn’t have to cajole frightened patients into letting him administer shots.
Parents can help, too. Recent research supports Fellner’s belief that breast milk might be the perfect pain reliever for infants. And, Berberich says, “If the parent says, ‘I would rather have my child in my lap, most pediatricians would agree.”
With toddlers own up; be honest. Don’t say the shot won’t hurt, but also don’t say it will hurt only a little. Best to say “I don’t know how it’s going to feel for you,” and change the subject to what treat you have planned for afterward.
In his practice, Berberich tops off children’s shots with a cookie.
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