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Clinical Tip: To take the fear out of shots, plan ahead

For the child who dreads shots or the anxious parent who cringes at the thought of her infant receiving several immunizations at a health-maintenance visit, I offer a prescription of EMLA anesthetic cream. I instruct the parent to apply a glob of it at the injection site the morning of the appointment (or at noon for an afternoon appointment) and cover the site with a small adhesive bandage to mark the target. The strategy works like a charm to calm both children and parents. Our patients are now so accustomed to "painless shots" that the office staff offers an EMLA prescription routinely when scheduling health-maintenance visits that involve immunizations-and parents sometimes call in advance to request the prescription.

Stuart Trust, MDFulton, N.Y.