Children and needle phobia

What is needle phobia? 

It’s estimated that needle phobia affects 1 in 10 people so if your child feels this way they are not alone.   

It’s normal to dislike needles, but a fear or dislike becomes a phobia when it leads to problems. For example, if a fear of needles stops your child from having the insulin they need. 

What are the signs of needle phobia?  

If your child has needle phobia, coming into contact with needles may cause them to feel: 

• Scared 
• Tearful 
• Hostile or agitated 
• Dizzy or faint 
• Like they want to run away 

How can needle phobia affect type 1 management?  

When you have type 1, needles are a part of everyday life. If someone with type 1 doesn’t like needles, they might start avoiding them and stop taking insulin or checking their glucose levels.  

This can cause their glucose to be unstable, causing hypers or hypos. In severe cases it can lead to diabetic ketoacidosis (DKA), which can be life-threatening.  

There will be needles and finger pricks at your child’s regular blood tests to check their HbA1c and overall health. They’ll also need to get vaccinations against illnesses like flu and covid. 

Can you manage your child’s type 1 if they have needle phobia? 

You might have to do things a little differently, but you can still manage your child’s type 1 if they have this type of phobia. 

You can take steps together to overcome their phobia (see below) and put strategies in place. This might be: 

• helping them to inject or injecting for them  
• finding ways to prepare them mentally and emotionally for injections, insertions or site changes 
• having a special routine around injections that makes them feel more comfortable 

How can I help my child with their needle phobia?  

Here are some tips to help your child relax around needles. 

Relax together 

Together, take slow deep breaths into your bellies. This can help to relax your child’s body and stop the release of stress hormones.  

Some people find it helps to tense their muscles as hard as they can and then relax them a few times. 

Give your child a playlist of relaxing music or their favourite programme before and/or during the injection.  

Distract them 

Try giving your child something else to focus on, such as:  

• Play I spy in the room – see how many things you can find for every colour of the rainbow 
• Ask them to think or talk about something positive, like fun plans for the holidays 
• Give them something to look at on your phone, a game to play, some music to listen to or something to read  
• Ask them to think of a list of things that start with every letter of the alphabet. For example, an animals list would start Aardvark, Bee, Caterpillar… 

Make friends with Rufus! 

You may have been given a Rufus, our teddy bear with type 1, when your child was diagnosed. Rufus has patches on his arms, legs, tummy and bottom to show children where to inject and help them practice. He can be a great comfort for children who are scared or uncomfortable about injecting their insulin or checking blood glucose levels. 

Find out how to get a Rufus bear. 

Keep things sharp 

The needle tops for insulin pens are single use and should be changed every time your child uses them. It’s the same for the lancets in their blood glucose meter.  

If you don’t change them regularly it’s likely that they will become blunt. This could cause unnecessary discomfort. It might also put your child a risk of developing lumps under the skin that can stop their insulin working properly. 

Feeling faint 

If your child has needle phobia, they may feel faint during an injection. The fear of fainting during an injection can add to you and your child’s overall worries. 

Your child can try lying down with their feet up whilst they (or you) inject. This can help stop the blood rushing to their legs and feet and making them feel faint. They can also try crossing your legs and clenching hard (like they’re desperate for the toilet).

Tackling their phobia one step at a time 

One way to overcome phobias is to break them down into little steps that you overcome one at a time. You can use a technique called the worry ladder (sometimes called a fear ladder) to work through this with your child. 

Together, think of ten situations involving needles. Give each one a mark out of ten for how anxious each one makes your child feel, with 10 being the most anxious they feel and one the least. For example, you might give a mark of one out of 10 for a picture of a needle, and 10 out of 10 for having a blood test.

Start at the situation with the lowest mark, for example the picture of the needle. Ask your child to keep looking at it until they are completely bored with it. 

When you’ve done this, give your child a reward and move up to the next level. 

Things at the top of their worry ladder may feel completely unreachable right now. Working up gradually will help it feel more achievable. 

Find out more about using a worry or fear ladder in Talking Type 1’s Not OK with Needles workbook. 

Use type 1 technology 

Type 1 diabetes technology doesn’t replace needles but using continuous glucose monitors (CGMs) and insulin pumps can reduce how often your child encounters them.  

A CGM is worn on the upper arm with a small wire that goes under the skin. You change the sensor every six to 14 days (depending on the type of CGM that you have). 

Micro or patch insulin pumps are stuck directly onto the skin. They need to be changed around every three days. 

Tethered pumps attach to you through a tube, cannula and/or needle (known as infusion sets). The needle is taken away once the cannula is in place and the cannula needs to be changed every two to three days. There is usually a choice of infusion sets, so talk to your child’s Diabetes Healthcare Team about what might work for them. 

Learn more about CGMs, insulin pumps and what is available on the NHS in our Guide to Type 1 Technology. 

Products that can help 

Tickleflex is an accessory that you can attach to the end of your child’s insulin pen. It makes injecting more comfortable and consistent. 

i-Ports are small injection ports that you wear for up to three days. It means that you will only have to puncture your child’s skin when you apply the port instead of for each injection. They can wear an i-port during normal activities like sleeping, bathing and exercising. 

Where can I find support?  

If your child is struggling with needle phobia, speak to their Diabetes Healthcare Team. They may be able to work through techniques with you and your child or refer them to a psychologist. 

You can find information and activities to help you and your child work through needle phobia in the Talking Type 1’s Not OK with Needles workbook. 

There is also information and advice about needle phobia on Anxiety UK and Guy’s and St Thomas’ Hospital Needle phobia and overcoming your fear page.

This content was developed from Talking Type 1’s Not OK with Needles workbook, written by Dr Rose Stewart in collaboration with people living with diabetes and NHS diabetes healthcare professionals.