A Parent’s Guide: Kids and Subcutaneous Injections

If your child is diagnosed with a condition that needs subcutaneous injections to treat it, you may worry about how to give these injections and how your child will cope.

Joel Hahnke, MD, a pediatric endocrinologist with Banner Children’s, said, “Parents often have more concern and worry about these shots than their child does. While some kids are afraid of needles due to previous experiences with vaccines, blood draws or IV line placements, subcutaneous shots are a different thing altogether. Most kids realize within the first few doses that these injections are not nearly as painful as they feared.”

Still, it’s important to know how to give these injections properly and how to calm your child’s fears.

What are subcutaneous injections?

Subcutaneous injections are injections that go into the layer of tissue that’s just below the skin. From there, the medication can be absorbed into the bloodstream.

Compared to muscles, this area has fewer nerve endings. Smaller needles can be used for injections under the skin compared to injections in muscles. So these injections are generally less painful.

“They are nothing like common vaccinations that are given into the muscle and may cause soreness for several days,” Dr. Hahnke said. “Modern subcutaneous medications have benefited from technological advancements in injection devices and needles. We use some amazingly short and thin needles that truly minimize injection site pain.”

These injections are usually used for medication that can’t be taken by mouth, needs to be absorbed slowly or could cause discomfort if injected into a muscle. Your child might need them if they have type 1 or type 2 diabetes, rheumatoid arthritis, psoriasis, Crohn’s disease, blood clots or growth hormone deficiency.

How to give an injection

These steps can help ensure you give a subcutaneous injection properly:

Gather your supplies. You’ll need the medication, alcohol wipes or cotton balls and alcohol, a sharps disposal container and possibly a gauze pad or bandage.
Wash your hands thoroughly with soap and water and dry them with a paper towel.
Prepare the medication according to your health care provider’s instructions.
Choose an injection site. Often, it’s the abdomen or upper thigh. Change injection sites regularly to keep the tissue from being damaged or irritated.
Clean the site with alcohol and let it dry.
Pinch a fold of skin to create a small, raised area.
Insert the needle swiftly and firmly into the skin fold. You’ll usually insert it at an angle of 45 to 90 degrees, depending on how long the needle is and how much tissue you’re injecting it into.
Inject the medication slowly.
Remove the needle at the same angle it was inserted.
Apply gentle pressure to the site with a clean cotton ball or gauze pad.
Dispose of the needle and syringe safely in a sharps disposal container.

If you have any concerns or difficulties, ask your child’s health care team for support and guidance. They can offer advice and answer any questions. You may also want to connect with other parents of children who need subcutaneous injections for insights and support.

How to keep your child comfortable

At first, your child may be scared or worried about these injections. It can help if you:

Choose a quiet, comfortable place for the injection.
In an age-appropriate way, explain honestly why your child needs injections and how they keep your child healthy.
Let your child ask questions and express their feelings. Validate their emotions.
Reassure and encourage them.
Distract them by singing a song, counting, blowing bubbles or watching a video. “Just looking away from the injection is often enough to reduce pain and fear significantly,” Dr. Hahnke said.
Put ice, a cold spoon or numbing cream on the injection site beforehand, if your provider gives you the OK.
Ask your provider about injection pens that hide the needle or products like Buzzy, TickleFLEX or shot blockers. “They will desensitize or confuse the pain sensors in the skin so that kids do not feel injections,” Dr. Hahnke said.
Have another person hold your child if you think they might move suddenly.
Let a child who is old enough choose the injection site or make other decisions, so they feel more empowered.
Practice relaxation techniques like deep breathing or visualization together so your child feels more in control.
Administer the injection quickly.
Soothe your child afterward and offer a sticker or small reward.

Tips for kids who do their own injections

“Many people are surprised to learn their children may give their own shots. Given the variations in maturity, temperament and fear among kids, it’s hard to specify an age recommendation. In my experience, by the age of 8 to 10 years, most kids are giving at least some of their own shots, but I also have younger patients who give their own shots and older patients who still refuse to,” Dr. Hahnke said. “We recommend that adults supervise all injections until a kid is mature enough to be able to handle this independently, which is usually in adolescence.”

You can help your child learn to administer their own injections by:

Teaching them proper injection techniques and making sure they understand why hygiene and safety are important.
Supporting and encouraging them.
Setting guidelines for following the dosage and schedule.
Making sure they know to watch for side effects or complications.
Encouraging open communication about any concerns or difficulties.

Safety tips

It’s important to dispose of used needles properly. Otherwise, they could cause injuries or spread infections. Dispose of needles in a sharps container, not in your household trash. You can get a sharps container from pharmacies or health care providers. Follow local regulations for getting rid of sharps containers when they are full. Never reuse a needle.

“Adverse effects from injections are minimal as long as you follow the proper technique. Since modern needles are so short and thin, not putting the needle in far enough may cause swelling just under the skin surface, but this typically goes away within a matter of seconds to minutes,” Dr. Hahnke said. “Bleeding may occur, but it is uncommon for a subcutaneous injection site to bleed for more than a minute, and a Band-Aid is usually more than enough to stop it.”

Watch for these side effects from subcutaneous injections:

Redness at the injection site
Mild pain
Fever, chills or other signs of infection
Signs of an allergic reaction, such as hives, difficulty breathing or swelling of the face, lips or tongue

Get help immediately for signs of an infection or allergic reaction. Talk to your provider if you have concerns about any other side effects or symptoms.

Communicate with your child’s health care team

If your child needs subcutaneous injections, you’ll probably feel uncertain at first. It may help to ask questions like:

What is the purpose of the medication my child needs?
What are the possible side effects or risks? What should I do if I see any signs of them?
Are there any specific instructions or precautions I should follow?
How should I store the medication and supplies?
Can you demonstrate the proper technique for administering these injections?
How often should my child receive these injections, and for how long will they need them?
Are there any alternative treatment options or additional resources available?
When should I schedule follow-up appointments?

The bottom line

If your child needs subcutaneous injections to treat a medical condition, you may be apprehensive at first and your child may be worried or fearful. However, these needles are smaller than many others and are injected in places in the body where they are less likely to cause pain or discomfort.

By learning proper techniques and strategies for comforting your child, you’ll both become comfortable and confident with the process. If you’d like expert advice on these injections or other aspects of your child’s medical condition, reach out to an expert at Banner Health.

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Subcutaneous Injections for Children: What Parents Should Know