Everyone who has type 1 diabetes has to take insulin multiple times a day. Many people use an insulin pump, but for people who do daily insulin injections, it can be difficult to psyche yourself up to inject yourself each time. And when it’s a parent trying to give insulin to their child, it can become even more challenging.
Often, children will fight their injections. From trying to hide at injection time, to refusing to eat in the hopes of avoiding a shot, to outright kicking, biting, and screaming… some children will do anything to avoid getting poked.
When you have to convince, argue with, or physically hold down your child multiple times a day to give them an injection, it can be emotionally and physically exhausting. Of course, you don’t want to do this, but if they don’t get their insulin they will die.
While we don’t have a choice about giving our children insulin injections, we do have some options regarding how we go about it. Let’s talk about some techniques and gadgets that will make your child’s injection time smoother. You can successfully get through insulin shots without fighting and tears.
This article has been sponsored by Ypsomed Diabetescare Inc. All opinions are mine.
(This post contains affiliate links. That means, if you click on a link and make a purchase, I may receive a small commission. I only share products that I believe will help families dealing with T1D. Thanks for helping me stay caffeinated!)
First things first: Why is injection time difficult for your child?
It may seem silly, but this is an important question. Usually, the problem with injections is simple… it’s painful. However, that’s not always the case.
Some children have trypanophobia (fear of needles) and it’s the idea of getting an injection that bothers them, not the actual injection itself.
Others may have auditory or visual cues that are bothering them. The click of a pen needle, seeing the needle tip itself, or the beeps of a CGM may cause anxiety even if the shot itself is essentially painless.
If your child is old enough,
Try having a discussion with them to pinpoint what it is about injection time that is upsetting for them. It’s best to do this at a time when you don’t need to give an injection. That will help keep the urgency (and often frustration and irritation) out of the conversation.
If your child is too young to communicate effectively,
Or if they are unable to pinpoint or explain what the problem is, pay attention to non-verbal cues and brainstorm potential solutions with them. Even toddlers can help in big discussions. Children often feel validated and understood when they are able to participate in the conversation.
It’s a great idea to read up on potential problems before talking to your child. Let’s go over several common issues that come hand in hand with insulin injections, and some suggestions on how to resolve the stress of needle time.
Burning or stinging sensations at injection sites
Most of us have had an injection at some point in our life, even if we don’t have T1D. I think most people can understand that it’s not exactly a pleasant experience. It pinches a bit and can feel tender afterward.
However… insulin should not cause a burning or stinging sensation. If that’s happening, there are generally 2 culprits:
Lantus and its biosimilars
Lantus is a commonly used basal insulin. It is the only insulin on the market that has a known burning sensation. If your child is using Lantus and finds their basal dose difficult to endure, you might want to talk to their diabetes team about switching to a different brand.
There are several basal insulins to choose from. They have different duration profiles so check with your doctor to see if you need to adjust the dose amount before switching. I honestly don’t know why newly diagnosed people are put on Lantus when it’s known to be more painful than the rest. It could be because of insurance for some people. If that’s the case, see if you can get special authority for a different brand from your doctor. T1D is hard enough without adding burning to the mix.
Allergies
If your child says their insulin feels like it’s burning, but they aren’t talking about Lantus, they could have an allergy. They might be allergic to the insulin itself, one of the other ingredients, or even the surface treatments on the syringes/ pen tips themselves.
More people are allergic to insulin than you may realize. There have been a few people who are severely allergic to almost every brand, but more often, there is just a bit of discomfort, itchiness, or unexplained rashes.
If you believe your child might be allergic to their insulin, talk to their doctor. They’ll be able to do allergy tests, troubleshoot, and switch insulin brands if necessary.
Auditory issues and simple solutions
Your child isn’t experiencing burning during injection time, the shot doesn’t even seem to be causing pain at all. Yet, they’re still fighting you before every bolus. What is going on?
It may be that the injection itself isn’t painful, but there are auditory cues or loud noises that are upsetting to your child. Some insertion sets have a loud snap sound upon insertion. Things like the click from priming an insulin pen, the zipper of their case unzipping, or a package of insulin being opened might trigger feelings of anxiety.
Here are a few suggestions for children who are anxious due to auditory input:
Headphones or earmuffs
You could get some special noise-canceling headphones for your child. Some children might not even need that much. Simply muffling the sound often does the trick too. Why not grab a pair of unicorn earmuffs to use during injections?
These options can give your child a task to do while you’re prepping their shot. They find and put on the headphones, you get the insulin. It can also feel comforting and snug around their heads.
TV shows and videos
If your child needs a distraction from the process of injections, and you allow screen time in your house, TV or YouTube videos might be helpful. You and your child could find something that they’re particularly interested in (my son enjoys videos about video game hacks), and give their injection while they’re watching.
Especially since most people utilize pre-bolusing now, there’s no reason to get them to turn off a show if they’re currently engaged. Stopping a current activity to do an injection might cause an excess of difficult emotions.
Music
Listening to music works well for some children. Of course, you don’t want to create a dance party, it wouldn’t be easy to give an injection to a child who is bouncing around and dancing. But, if you can find some music that your child finds soothing, whether it’s through headphones or household speakers, music can help calm your child down before injection time.
If your child is old enough, you might want to make a playlist together that is special for T1D management times or to listen to when they’re feeling overwhelmed.
Toys that talk, sing, or make noise
Maybe screens and music aren’t enough for your child. Maybe they need a more hands-on distraction. Toys that ask questions, sing songs, or make other interactive noises can be very helpful at injection time.
For younger children, something like a Violet or Scout stuffy might do the trick. Older children might enjoy an interactive game like Simon. Really, anything that will keep their minds off of the fact that they’re about to get a shot.
Injection techniques and products
For most people, the problem with injections is that it’s painful. It’s a small pinch, but knowing that you have to do it multiple times every day for the foreseeable future can make it much more daunting.
Here are some things to consider that could make injections less painful for your child:
Gauge and length
Pen tips and syringes come in different gauges and lengths. There are reasons why people might need a bigger gauge or longer needle, but in general, for insulin, you want thinner and shorter needles. This is something that you can discuss with your doctor.
Many doctors have a default prescription that they write for every newly diagnosed person with T1D. This may or may not be the best fit for your child. The most commonly used length for pen tips is 4 or 5mm and the most common gauge is 31 or 32. Lower numbers for the length mean it’s smaller, higher numbers for the gauge mean it’s thinner.
Clickfine pen tips have a few extra features that allow for smoother and faster injections as well. Grab your free sample here.
Proper injection technique
The way you do injections is critical. Different techniques can cause more pain and will make insulin absorption vary. And doing things like reusing pen tips make each injection more uncomfortable and also increases the chance of infection.
Insulin is meant to be injected subcutaneously into fatty tissue. If it is injected too deep, it will go into muscle, which can cause sudden hypoglycemia.
Here are some additional tips and tricks about injection techniques from Ypsomed: The Correct Injection Technique
iPort
If it’s near impossible to do injections on your child, you might want to consider getting an iPort from Medtronic. The iPort is a site that is inserted on the body, exactly like a pump site, but without the pump.
It stays on for 3 days and then you take it off and insert a new one. That means, what used to be upwards of 18+ pokes over the course of 3 days becomes 1 every 3 days. You still inject manually each time, but you’re injecting into a port, so your child won’t feel the individual injections.
The iPort does require longer needles, you have to be aware of the potential for bent cannulas, and you can’t inject your basal insulin into it, but it drastically reduces the number of pokes your child will get. If you’re not able to get an insulin pump (possibly due to insurance or your doctor not approving one), an iPort is the next best thing.
Insulin pumps
This is the solution that most people suggest when your child is resistant to getting injections. One of the biggest benefits of an insulin pump is reduced pokes. But keep in mind, while the number of pokes is far less with an insulin pump, the insertion itself can be loud (depending on the pump brand) and the cannula is longer and thicker than any pen tip or syringe.
There are several options if you want to start pumping. Each insulin pump has slightly different features. There isn’t a “best” insulin pump. Talk to local reps of pump companies, your endo, and other people in the T1D community to get an idea of which insulin pump would be best for you.
The YpsoPump has an app that you can download for free to try out all of the features. You might be able to get samples of different pumps (with saline) from reps or your diabetes team. Insulin pumps are extremely expensive, so make sure your insulin pump is going to be covered or that you are able to pay for it out of pocket before starting the process.
Numbing tricks and products
If the actual pinch of the needle is the problem, there are a few options to numb the area before injecting. It’s an extra step, but if it helps reduce the stress for you and your child, it’s worth it.
Numbing cream
Emla or lidocaine can be used to numb the area before injections. There’s a fairly big drawback to this option though. These creams take quite a while (30+ minutes) to take effect. So you have to be able to plan your shots accordingly.
Buzzy Bee
Buzzy Bee is a cute little product that uses a massage-like vibration as well as cold temperatures to decrease the pain of injections. Children often enjoy the cartoonish shape and face of the bee. It’s a great way to distract your child while also reducing the actual feeling of the needles.
Frozen spoons
The simple and free solution! Put an ordinary kitchen spoon from your cutlery drawer into the freezer. Before shots, take the spoon and numb the area by placing it against the skin for a couple of minutes. So fast and easy!
Empowering options
Believe it or not, often our children don’t mind the sounds or sensations that come with insulin injections. So why do they still fight against getting shots? It sometimes boils down to autonomy.
Let your child give their own injection
Yes, even if your child screams and cries when it’s time for an injection. Offer the option of them doing it themselves, age-appropriate of course. Having control of how the shot is given can be much less scary than having someone else do it.
If your child isn’t at an age where they can do an injection themselves, maybe they can be involved in other ways. They can push the plunger with you or do a “3, 2, 1…” countdown with you. These options take some of the unknown out of the equation.
Choices are amazing
Along the same lines, try giving your child more choices with their injections. Not unlike offering a blue or green cup for their water, you can give your child choices about their insulin.
The injection itself has to happen, but there are smaller things that they can decide for themselves.
“Would you like to do it or should I?”
“Do you want this one in your arm or your tummy?”
“Should we do it now or in 3 minutes?” You might want to set a timer for this one if they pick the later time.
These types of options give your child some control over what is happening to their body. When giving choices, always make sure that both options work equally well. You have to be able to agree with whatever they choose, so be intentional with the options you provide.
Practice, practice, practice
Especially when they’re younger, children deal with difficult situations and emotions through play. Pair a toy medical kit with a Rufus bear and allow your child to give their stuffed toy pretend injections. If you pay close attention while they’re playing, you might even notice how your child comforts the stuffed animal and adopt those habits when it’s your turn to do the consoling.
Or, you can let your child take a play syringe and give you or other adults “injections”.
Some people will even use a real syringe with saline to do injections with their child. This can be beneficial not only because you’re modelling the behaviour you’d like to see when your child gets their shots, but also because you’ll have first-hand knowledge of exactly how those shots feel.
Empathy and brainstorming can make all the difference
Consider yourself at your child’s age. How would you have felt if multiple times every day you had to stop doing things you enjoyed to get a shot? Or if every time you ate, especially with other people, you had to inject insulin first while everyone around you could simply start eating?
Because it’s something that our children have to do, and they have to do it frequently, sometimes we can forget how hard it must be. Many people even think that they should just get over it and just do what needs to be done.
The reality is, it can be necessary and it can be hard, really hard. There will be times when it’s easier and times when it’s more difficult. Times of acceptance and times of denial. Insulin injections are just the tip of the iceberg. They’re the easy part. T1D also comes with burnout, increased mental health problems, and a much higher likelihood of developing eating disorders.
That’s why it’s so important to keep your child’s perspective in mind. Try not to assume what the problem is, ask them. Have a discussion, make observations, and then brainstorm solutions together.
You know your child best. Some children need to prepare for things like injections while others would worry themselves sick with too much time to think about it.
Working together as a team will always help you overcome the hurdles that T1D puts in your path. Remember: it’s not you against your child, it’s you and your child against T1D.
~ Leah
Have you had problems with your child and insulin injections? What helped your child adjust? Was it suggested in this article? Let’s chat about it in the comments!
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