“Children should not only not have any medical procedures performed on them without consent, they should be in control throughout.”
– Sarah Fitz-Claridge
First, vaccinations are something to discuss with your doctor. I am in no way qualified to advise about the wisdom of vaccinations. But if you or your child is having an intramuscular injection, some say it is safer if the person giving the injection aspirate the needle to check that they are not about to inject it into a blood vessel, and only when they have confirmed that there is no blood, then push in the plunger. Some countries do insist on this, but Britain and the USA do not. The risk is very low, but for the person who does sustain possibly permanent organ damage as a result of the injection going straight into a blood vessel, it is not a great comfort to be told that that was super unlucky and rare. Aspirating might well have made a difference. Which is why some countries insist on aspiration before injection.
Secondly, medical treatment, however essential and however benevolently intended, applied to a child against his will, is exactly as wrong as it would be if the patient were an adult—and more so when it involves betrayal by trusted people who are responsible for the child’s welfare (i.e., the child’s parents). Children should not only not have any medical procedures performed on them without consent, they should be in control throughout. If this involves the parents annoying the medical professionals, so be it. (In my experience medical doctors have never been annoyed, or if they have been, they have not given any hint of being.)
Moving on to the practical point, no baby or child should ever feel the pain of an injection (except possibly in a situation of extreme urgency where they have much bigger worries anyway).
Always use a local anaesthetic cream like Emla (each gram of it contains 25mg Lidocaine plus 25mg Prilocaine in a water-miscible base — manufacturer in the UK: Astra pharmaceuticals).
It is completely effective, when used correctly, though using it is slightly tricky, the main difficulties being:
- It is only effective if it is applied TWO HOURS in advance.
- In the case of infants, a gauze has to be applied, and kept over it during those two hours.
- You have to remember exactly where you applied it (suggestion: use a felt-tip pen to mark the spot).
- It is prescription-only, and some people think that some medical practitioners see no need for pain relief for children. But again, I have found our GPs very happy to prescribe it, and have had no problems asking them to wait for the Emla cream to take effect before proceeding. Perhaps it helps to assume the best and speak to medical professions in a pleasant manner rather than speaking to them in a hostile, pessimistic, accusing way?
Children thus taken seriously typically smile and chat through any injection (and even significant medical procedures).
A 5 gram tube of Emla cream is enough to prepare for about 2-5 vaccinations. It is important to apply a thick layer, not thin as you would if you were applying ointment, and to cover it in something like cling film, in such a way that it does not disperse too far from the site by the time of the vaccination.
Final comment: pain relief is only a necessary, not a sufficient condition for making procedures such as vaccinations distress-free for young children.
See also:
- Why do you like IFS but not ‘Self-led parenting’?
- What is the relationship between Karl Popper’s epistemology, the ideas of David Deutsch and Taking Children Seriously?
- Surely children need to learn to deal with restrictions to prepare them for life in society?
Sarah Fitz-Claridge, 2022, Taking Children Seriously FAQ: ‘What do you do about vaccinating your children?’, https://takingchildrenseriously.com/what-do-you-do-about-vaccinating-your-children/
A note on the practical point:
I much prefer the pain of a vaccination to an anaesthetic, and have had this preference all my life. (Including very early childhood, when I did not yet know such things were possible, had never been exposed to them, and had only hypothesized!) Pain is a warning, in my world, and to block or reduce it without explicit consent is akin to cutting the power to a home alarm system.
It is essential to check with the child as early as possible, and continue doing so often.
As it turns out, my body also reacts poorly to anaesthetics, including by permanently increasing my pain sensitivity. My parents forced quite enough of the stuff on me in very few exposures, and I am glad they had never heard of local anaesthetic creams. Just as a young child may know that some food makes them ill but not have the words to say “I’m allergic to that”, let alone some more subtle food intolerance, they may also have similar problems with medication – and that includes anaesthetics and painkillers of any kind. If a child attempts to remove or otherwise shows any dislike of the cream, LET THEM; those are the communication tools they have.
Because of the increased pain sensitivity, vaccinations involve several days of soreness for me – which would have rapidly given away the cream being used to conceal something about the vaccination itself, and I would have considered that a great betrayal despite good intentions.
My medical distress, both as a child and as an adult, was never about pain per se. It was always about people (whether my parents or medical professionals) making assumptions about what would be in my best interests; that is, not treating me as an individual and taking me seriously. I STILL fire doctors over this with regularity, because some are too used to “cookbook medicine”.
When I was forced through medical procedures, I suffered whether or not I felt pain. When I choose a procedure for myself and am in control of it, I may feel pain but I do not suffer.
I’ve had stitches out, I’ve had enough blood tests to tell the technician in advance if my vein will collapse, I’ve done years of rehab that involved breaking muscle fibers every single day. All of it was painful, but none of it was suffering to go without chemical pain relief – because that was and is my choice.
I very much agree with your teachings of respecting children as we would adults. I think it is important to acknowledge that when someone in your care is unable to consent to life-saving or otherwise essential for quality of life treatment, the caregiver is responsible for ensuring their dependent receives necessary care.
My very young child is medically fragile and has needed many medical procedures to keep her alive. She did not and could not consent to them, but if I refused to allow her to be treated on the basis of lack of consent, she would be dead.
I know this circles back to your argument about saving someone from walking in to traffic, but I feel it is important to reiterate here in a medical environment. Particularly when there are so many who push their beliefs and preferences about medical treatment onto their children to the detriment of their child’s health.
Just as they cannot consent at times to receive care, they also cannot consent then to not receive it.