New study finds it’s not just what say, but when you say it that can keep preschoolers calmer during vaccinations

TORONTO, July 13, 2021��– As we look forward to a fall with hopefully one of the most important vaccination uptakes of children in a generation, a new study provides insights to help parents with reducing post-vaccination distress in younger kids. The study,��published in , looked at preschool children who were at least four-to-five years old and what their parents said that could help reduce distress during their vaccination. This study is part of the largest study in the world looking at caregivers and children during vaccinations from birth to the age of five — coined the OUCH Cohort.��The OUCH Cohort originally followed 760��caregiver-child dyads from three pediatric clinics in the��Greater Toronto Area��and were observed during vaccinations during the first five years of a child’s life.

“What we found is that in the first minute after the needle, the more parents said coping-promoting statements, such as ‘you can do this’ and ‘it will be over soon’ or tried to distract them with talking about something else, the higher distressed the children were. This really surprised us,” said Rebecca��Pillai��Riddell, senior author, professor in the department of psychology, Faculty of Health and Director at the OUCH Lab at 91��ɫ. “We found however, during the second minute after the vaccine, when the child was calmer, these same coping promoting statements resulted in them calming down faster. On the other hand, distress-promoting statements, such as criticizing the child, or reassuring them they were fine, had no relationship with child distress in minute-one but and in minute-two, the distress-promoting comments were strongly predictive of higher distress in kids. We also showed with preschoolers that the more distressed they were prior to the needle, the more distressed they were after the needle — like a domino effect of previous pain.”

“Previous research has shown that the vast majority of preschoolers calm down within two minutes after a vaccination, however, about 25 per cent of children did not. We wanted to determine what parents were saying before or during the vaccination appointment that could be leading to these children feeling distressed during and after a vaccination,” said Ilana Shiff, first author and master’s student in Pillai Riddell’s lab.

Based on their findings, the researchers recommend that in first minute after a vaccine parents��should not��start encouraging coping right away, but rather keep them calm by using physical��strategies��such as hugging, cuddling or hand-holding. This should be done instead of��trying to give a child verbal direction on how to cope when they are in peak distress. Once children get over that initial minute of high distress,��Pillai Riddell says, they think children are more able to get benefit from parents’ coping-promoting statements.��The findings also provide insight for��health-care��providers and caregivers on how to support children during immunization appointments.

Researchers say because preschool children show the prior pain ‘domino-effect,’ it is critical for health-care providers to try to vaccinate calm preschoolers. Routinely adopting techniques that allow the child to be approached without distressing them prior to the needle (e.g., allowing a child to stay close to their caregiver while viewing a video on a smartphone as a distraction) will help minimize the pain ‘domino��effect’ these findings suggest. Moreover, for both groups, supporting caregivers to avoid��distress-promoting��behaviours��before and during��the vaccination will be critical.

“This type of data has never been found in preschoolers before.��It’s important to understand post-needle reactions at this age because needle phobia and phobias in general start coming on at five to 10 years of age, so understanding how children can be coached and how parents can have a really powerful role in reducing stress post a vaccination is key,” said Pillai Riddell.

About 91��ɫ

91��ɫ��is a modern, multi-campus, urban university located in Toronto, Ontario. Backed by a diverse group of students, faculty, staff, alumni and partners, we bring a uniquely global perspective to help solve societal challenges, drive positive change and prepare our students for success. 91��ɫ's fully bilingual Glendon Campus is home to Southern Ontario's Centre of Excellence for French Language and Bilingual Postsecondary Education. 91��ɫ’s campuses in Costa Rica and India offer students exceptional transnational learning opportunities and innovative programs. Together, we can make things right for our communities, our planet, and our future.

Media contact:��Anjum Nayyar, 91��ɫ Media Relations, cell 437 242 1547,��anayyar@yorku.ca

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Thursday, September 24, 2020, TORONTO –��Being held by a parent with skin-to-skin contact reduces how strongly a newborn baby’s brain responds to a painful medical jab, finds a new study led by researchers at 91��ɫ and UCL (University College London).

The scientists report in the��that there was more activity in the brains of newborn babies in reaction to the pain when a parent was holding them through clothing, than without clothing.

“This work suggests that skin-to skin contact may actually help protect the brain when babies undergo repetitive skin breaking procedures, says joint senior author, Rebecca Pillai Riddell, professor, department of psychology at the Faculty of Health, and Director, The OUCH Lab at 91��ɫ. “Research has suggested that NICU skin-breaking procedures may impact the structure of the brain and if brains are less activated, they may have less detrimental impact.”

“We have found when a baby is held by their parent, with skin-on-skin contact, the higher-level brain processing in response to pain is somewhat dampened,” says joint senior author, Lorenzo Fabrizi, Senior Research Fellow Neuroscience, Physiology and Pharmacology Department at UCL. “The baby’s brain is also using a different pathway to process its response to pain. While we cannot confirm whether the baby actually feels less pain, our findings reinforce the important role of touch between parents and their newborn babies.”

The study involved 27 infants, 0-96 days old and born premature or at term age, at University College London Hospitals. The researchers were measuring their response to a painful but clinically required heel lance (blood test). Brain activity was recorded with EEG (electroencephalography) electrodes placed on the scalp.

The babies were either held by their mother skin-to-skin (wearing a diaper, against their mother’s chest), or held by their mother with clothing, or else lying in a cot or incubator (most of these babies were swaddled).

The researchers found that the initial brain response to the pain was the same, but as the heel lance elicited a series of four to five waves of brain activity, the later waves of activity were impacted by whether the baby was held skin-to-skin or with clothing.

“The slightly delayed response was dampened if there was skin contact with their mother, which suggests that parental touch impacts the brain’s higher level processing,” says Pillai Riddell.�� “The pain might be the same, but how the baby’s brain processes and reacts to that pain depends on their contact with a parent. Our findings support the notion that holding a newborn baby against your skin is important to their development.”

The brains of the babies that remained in the cot or incubator also reacted less strongly to the pain than those held in clothing, but the researchers say that may be because the babies were not disrupted by being picked up before the procedure, or else due to the success of the sensitive, individualized care they were provided.

The babies’ behaviour was not significantly different between the groups, although the skin-to-skin group did exhibit slightly reduced responses in terms of facial expression and heart rate. Other studies have found that skin-to-skin contact with a parent does affect baby behaviour, and may reduce how strongly they react to pain, but those studies did not investigate the brain response.

In the current study, the babies’ brain responses were not only dampened in the skin-to-skin group, but also followed a different neural pathway.

“Newborn babies’ brains have a high degree of plasticity, particularly that born preterm, and their development is highly dependent on interactions with their parents,” says Laura Jones, first author of the study and PhD in the department of�� Neuroscience, Physiology & Pharmacology at UCL. “Our findings may lend new insights into how babies learn to process threats, as they are particularly sensitive to maternal cues.”

Co-author Dr. Judith Meek, consultant neonatologist at University College London Hospitals adds,�� “Parents and clinicians have known for many years how important skin to skincare is for babies in NICU. Now we have been able to demonstrate that this has a solid neurophysiological basis, which is an exciting discovery.”

The study was funded by was funded by the Medical Research Council (UK) and the International Association for the Study of Pain.��

Holding a newborn baby close to your skin while they have an injection may help to reduce their experience of pain, according to a joint study with 's Professor Rebecca Pillai Riddell via

— 91��ɫ News (@91��ɫUnews)

91��ɫ champions new ways of thinking that drive teaching and research excellence. Our students receive the education they need to create big ideas that make an impact on the world. Meaningful and sometimes unexpected careers result from cross-disciplinary programming, innovative course design and diverse experiential learning opportunities. 91��ɫ students and graduates push limits, achieve goals and find solutions to the world’s most pressing social challenges, empowered by a strong community that opens minds. 91��ɫ U is an internationally recognized research university – our 11 faculties and 25 research centres have partnerships with 200+ leading universities worldwide. Located in Toronto, 91��ɫ is the third largest university in Canada, with a strong community of 53,000 students, 7,000 faculty and administrative staff, and more than 300,000 alumni. 91��ɫ U's fully bilingual Glendon Campus is home to Southern Ontario's Centre of Excellence for French Language and Bilingual Postsecondary Education.

About UCL – London’s Global University

UCL is a diverse community with the freedom to challenge and think differently.

Our community of more than 41,500 students from 150 countries and over 12,500 staff pursues academic excellence, breaks boundaries and makes a positive impact on real world problems.

We are consistently ranked among the top 10 universities in the world and are one of only a handful of institutions rated as having the strongest academic reputation and the broadest research impact.��

We have a progressive and integrated approach to our teaching and research – championing innovation, creativity and cross-disciplinary working. We teach our students how to think, not what to think, and see them as partners, collaborators and contributors. ��

For almost 200 years, we are proud to have opened higher education to students from a wide range of backgrounds and to change the way we create and share knowledge.��

We were the first in England to welcome women to university education and that courageous attitude and disruptive spirit is still alive today. We are UCL.

Media Contacts:
Anjum Nayyar, 91��ɫ Media Relations, cell 437-242-1547,��anayyar@yorku.ca

To speak to the UCL researchers involved, please contact Chris Lane, UCL Media Relations.

T: +44 (0)20 7679 9222 / +44 (0)7717 728 648, E:��chris.lane@ucl.ac.uk

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