Been a Long Time

Hello readers. It has been a long time since I posted to this blog. I was going to remove it from the Internet but have seen some recent activity and think that the information on it should be shared. I have since finished my degree and my child I spoke about in the blog has moved forward in life. He is now 6. WOW!!
The new challenges in his life are this entering school. He went for his Kindergarten shots last year and the same distraction techniques worked wonders. He walked from the appointment proud of how strong he was. He has had some struggles with the school system and I am reading this amazing book right now titled "The mind of boys". It recognizes the differences between boys and girls learning styles. It provides techniques on how to make your boy's school life successful. Once I have finished the book I will write about my findings.

I wanted to write today to develop some discussion. In the Province that I live in, in Canada, they have decided to use the "sugar soothers" a gauze wrapped around a sugar bunch that has been dipped in grape juice, to assist infants with pain management during immunizations. What are your thoughts about this?

Another support for communicating with your infant/toddler

While I was pregnant I attended a couple of baby seminars that talked about communicating with your pre-verbal child. The presenters spoke about sign language and your baby. One presenter told a story of her 14 month old child who was able to use his sign language skills to get himself, his Mom, his infant sister, and Grandmother out of the house because a fire had started in the kitchen. They lost the kitchen, but not their lives. (They were all in the basement with stair access through the kitchen). This sold me. I vowed to teach my unborn child sign language. I bought the DVD from the one presenter. My son loved it. He started learning at 6 months of age and by nine months was able to communicate approx. three- five signs. (more, fruit, water, finished, Mommy, Daddy). It was absolutely amazing.

I then stumbled on this great program out of the states called Signing time Kids. They sing, sign and incorporate activities to secure the sign in your brain. It's colorful and educational. My son loves it!! He likes singing the songs and signing them. The host of the show has colored band aids on her fingers that helps to distinguish which finger is which. I bought some colored band aids and put them on his fingers, "just like her Mommy". The only downside is that in our area, the show is on really early in the morning so we tend to miss it.
Signing is a great tool to help children express their pain. You can find signs for this on the Internet or on www.signingtimekids.com. We used it for our son, and when he is hurt and crying using his hands to describe where the pain is or how much it hurts is a great way to communicate.
Just wanted to share this amazing tool with other Moms.

I am wondering what people think of the new HPV (human papilloma virus) vaccine that is now available in some parts of Canada? I don't know about the U.S.A. What are people's feelings? I have mixed feelings, I feel that it has the opportunity to be a wonderful prevention tool, but that if not presented with enough education could make this generation of girls coming up, a little more free with their sexual practices. I wonder how many might feel that they are now immune to many STD's. I don't have a daughter yet, but feel that if I did, I would be wanting all the research available, one to assess the side effects, and two to see if the promiscuity rate in countries who have already initiated the practice have risen. It will be interesting to see.

Great Experience

Wow!! What a difference a little research and understanding makes. We went for the immunizations today and I used some of the distraction techniques I had read about, taking a toy from home, having Dad there, and singing songs. Although he still screamed, it didn't seem to have the same level of distress as the previous immunizations. I was refreshed to see that the nurse went through all the immunizations with me today, and when she was about to give the Intramuscular injections in his arm, I stopped her and asked for her to give them in the leg, no fuss she did. All in all it was a way better experience today. I am happy I started this course.

Next Immunization appointment

Tomorrow my son has his 18 month immunization administration. I am having mixed feelings about the whole experience, but after reviewing the literature surrounding pain management in infants/toddlers during immunizations, I feel more confident as a parent that I can help to decrease the distress felt by my little guy. As for change in the whole system, I am still pondering my next motivated step in this. My thoughts are to continue to review the literature and then possibly approach the clinician at the Public Health Unit here and discuss the literature out there surrounding this topic. It would be nice to discuss with this person as well, the possibility of implementing some of these techniques into practice at this Public Health Unit on a trial basis, part of Kurt Lewin's theory of change, moving. The process may be a slow one, but I think if the subject is approached properly and well supported with literature that is well read, and established the change from no techniques to teaching parents distraction techniques will be an easy transition.

Where are we in change?

Kurt Lewin's stages of change included unfreezing or unlearning, moving, and refreezing or relearning. It is this change theory I feel best applies to the topic of pain management in infants and toddlers during routine immunizations. I know many colleagues who state that infants and toddlers need to feel that pain and learn to cope with it, or that the pain involved is minor and short lived, or my favorite that the pain they feel is a normal part of life. Is pain a normal part of life. All throughout our nursing training we are taught to manage individuals pain and to understand the differences between acute and chronic pain. We spend time learning the different methods for pain reduction. As a society we look for ways to manage pain. I wonder then what is the difference between the pain associated with an immnization injection and the pain associated with some childhood illnesses. Do they not still develop the same response? Lewin's stage of unfreezing is applicable to the stage nursing is at right now with pain management in infants, toddlers and children. We are having to relearn, rethink our methods of pain control. It is a heated topic being studied worldwide with many researchers discovering that simple measures such as distraction make a long lasting difference in pain management for children. So back to Lewin's theory, we are unfreezing, relearning our approach to pain management, looking for the move to correcting the lack of understanding for our shorter ones.

Little pain as precursor

Thank you anonymous for posting your thoughts to this page. I tend to disagree with your opinion, but it is your opinion. Many reseearchers have completed studies on pain managment and it's effects of pain tolerance in later years. Taddio, Katz, Ilerich and Koren published a study conducted on the Effects of Neonatal Circumcision on Pain Response during Subsequent Routine Vaccination. Their preliminary studies suggested that the pain experienced by infants and neonates in the neonatal period may have long lasting effects on behaviour associated with pain in later years. Their study followed circumcised infant boys, those who had EMLA cream applied previous to the freezing for circumcision and those who had not, versus uncircumcised boys and their follow up immunizations at four-six month mark. Taddio et al found that boys who did not have EMLA applied prior to circumcision had a higher pain response to immunization injections than the EMLA group and the uncircumcised group. This study is providing growing proof that providing pain relief for minor procedures does help children cope better with procedures later in life. When we come across adults who are frightened of needles and ask how they fear developed they usually have a story of a painful procedure that involved needles, and describe that as their first fear. If we develop fears, then why do we brush off pain control in infants when undergoing medical procedures? Do they really learn to be tough? Remember that pain management does not always have to be medicinal.