Does your child scream at the sight of needles? Tell you he'd rather have the flu than a shot to prevent it? You're not sure who is dreading this next back-to-school booster more - you, who will have to hold your son down, or him.

An article in the May 2007 journal Pediatrics suggests that parents can ease a child's anxiety about shots or getting blood drawn through the art of distraction. Ploys like blowing bubbles or singing with your child can do the trick.

The authors stressed, though, that parents should not be too understanding if a child makes a fuss. Otherwise, the attention can increase the child's fears about what's to come. Parents need to be supportive but matter-of-fact about the shot. No apologies.

Explain to children that immunizations are a fact of life - that it's okay to feel a little scared, but taking care of their health is part of growing up.

Before the appointment

Wait till the day of the appointment to tell your child about the shot - an hour before if you can. That way, your child can prepare, but won't have time to worry.

Even babies can sense a parent's emotions. If children pick up on anxiety, they will grow nervous, too. If you aren't relaxed, ask a calm grandparent or spouse to be with the child during the shot. Above all, reassure your child that he or she will not be alone.

Other tips:

Explain how vaccines protect children and why some medicines have to be given this way.

If several shots are needed, ask your doctor if a combination vaccine is available.

Don't say the shot won't hurt. Stress that the prick will only last a moment.

Give children choices so they feel in control. Which arm do they want the shot in? Do they want big brother there?

Plan something fun after the appointment, like ice cream or a movie. Nursing can comfort an infant.

"Don't look"

Distracting your child starts in the waiting room. Read a book out loud or have your child bring a hand-held video game or headset for music. When it's time roll up your child's sleeve, stroke him or her and try these other diversions:

For infants

Bring a pacifier.

Comfort, hug and talk to your baby.

Pull out a favorite stuffed animal or blanket.

For young children

Blow soap bubbles.

Look at a picture book.

Sing a song together.

For older children

Have a few jokes ready to share.

Tell the child to squeeze your hand according to how much the shot hurts (which may prevent crying).

Have your child breathe in deeply through the nose and out through the mouth "to blow away pain."

Don't tolerate kicking or screaming. For children who get very upset, your doctor may be able to prescribe a cream or cooling spray to apply an hour before the shot to numb the skin. Placing an ice pack on the injection site minutes before the shot can also lessen the sting. Ask your doctor's advice about giving a non-aspirin pain reliever when you get home.

When the injection is over, praise your child even if he or she cried. Then, count your lucky days before the next vaccine is due!

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