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Pain Expert Calls on Clinicians to Stop Needle Pain for Kids

One of the world’s leading experts in pediatric pain management is calling upon clinicians nationwide to join an “Ouchless Jab Challenge,” to eliminate the pain, trauma and anxiety of needle jabs for young children.

Led by UCSF Benioff Children’s Hospitals pediatrician Stefan Friedrichsdorf, MD, the challenge aims to engage the clinical community to use simple techniques to address the single largest source of fear and anxiety for children in a health care setting.

“In a medical setting, children are overwhelmingly afraid of needles, and studies show that some kids are so afraid of needles that they don’t tell their families or doctors that they are sick or in pain,” said Friedrichsdorf, the medical director of UCSF’s Stad Center for Pediatric Pain, Palliative and Integrative Medicine. “Children with unrelieved pain turn into adults with much higher rates of chronic pain, anxiety and depression, and this can be prevented.”

An estimated 25% of adults have a fear of needles stemming from childhood, resulting in long-term consequences that include needle phobia, pre-procedural anxiety, disproportionately severe pain, and an avoidance of health practitioners.

The challenge calls upon clinicians to implement simple, age-appropriate steps to reduce needle pain and fear, ranging from numbing the injection site to using soothing, relaxing or distraction techniques that calm the child during needle procedures. Friedrichsdorf also encourages parents to request these techniques for their children.

A comfort promise

The “Ouchless Jab Challenge” offers simple steps to soothe and distract children prior to a needle procedure of any kind:

  • Numbing cream (such as over-the-counter 4% lidocaine cream) applied before each needle procedure
  • Sugar water or breastfeeding for infants 0 to 12 months
  • Comfort positioning, including swaddling infants and skin-to-skin contact with parents, and sitting upright for children – never holding a child down
  • Age-appropriate distractions

The “Ouchless Jab Challenge” is the first step of the Stad Center’s “Comfort Promise” to UCSF Benioff patients to “do everything possible to prevent and treat pain, including the pain of needles, for every child, every time.”

The “Comfort Promise” has been part of the Stad Center’s mission since it was formed in 2022 with a gift from Elisa and Marc Stad as an intensive, interdisciplinary and rehabilitative inpatient and outpatient pain clinic that treats children and teens affected by acute and chronic pain, including the discomfort from sickle cell disease. Co-led by a primary care nurse practitioner, Barbette Murphy, MSN, and a therapeutic child life specialist, Kristen Beckler, MEd, the Comfort Promise has been rolled out to the first of many units at UCSF Benioff Children’s Hospitals.

The center has served several thousand patients to date and is now one of the most innovative and comprehensive programs of its kind in the nation. Friedrichsdorf now leads an extended, specialized team of integrated medicine and pain experts who provide consultative services with state-of-the-art technology and innovative techniques to work collaboratively with providers from across the health system.

Held down as a child

Friedrichsdorf remembers being traumatized as a child, when he was held down for a medical procedure while screaming in pain. In adulthood, he vowed to find a better way to acknowledge children's pain and do whatever possible to minimize it.

More than 1 in 5 youth suffer from severe chronic pain, such as headaches/migraines, abdominal pain, and muscle and joint discomfort, as well as acute pain from underlying diseases such as sickle cell disease. The Stad Center treats children from birth into their teens using multiple modes of pain management, combining advanced and safe pain medications with physical therapy, psychology, nerve blocks and integrative therapies.

Integrative therapies include acupuncture, acupressure, massage, aromatherapy, meditation and clinical hypnosis. The center also specializes in pediatric palliative care, with the goal of improving the quality of life for children with life-limiting illnesses, allowing them to live as long and as well as possible.