C.O.R.E. Promise

Comfort positioning

• Sitting in a caregiver’s lap
• Chest-to-chest hugging
• Avoid lying flat or being held down, with some exceptions

One primary voice

• Create a calm environment
  • Hushed tone of voice
  • One main voice speaking to the child
• Soothing music or sound machine

Reduce pain

• Sucrose (up to 24 months) by mouth for pain relief
• Breastfeeding for pain management
• Sucking on a pacifier
• Numbing cream
• Buzzy® (device that uses vibration to distract from pain)
• J-tip (needle-free device that gives numbing medicine) Note: This needle-free device makes a sound when activated. If using this method, we suggest that you let your toddler know what to expect and use noise-canceling headphones and distraction.

Every child, every time
Each child has their own ways of coping. St. Jude staff will ask what works best for your child. Distraction, preparation, the presence of a caregiver, and play can help reduce pain and provide comfort. Here are a few techniques that may help your toddler:

• Interactive music or songs
• Visual distractions
• Peek-a-boo
• Sound or sensory books
• Interactive toys
• Fun or educational videos
• Comfort provided by a caregiver

Comfort positioning

• Sit by themselves, in a caregiver’s lap, next to a caregiver on the bed, or in a chest-to-chest hugging position with a caregiver
• Offer to hold hands
• Avoid lying flat or being held down, with some exceptions

One primary voice

• Create a calm environment
  • Hushed tone of voice
  • One main voice speaking to the child
• Soothing music or sound machine

Reduce pain

• Numbing cream
• Cold spray Note: Cold spray is not recommended for children under age 4.
• Buzzy® (device that uses vibration to distract from pain)
• J-tip (needle-free device that gives numbing medicine) Note: This needle-free device makes a sound when activated. If using this method, we suggest that you let your child know what to expect and use noise-canceling headphones and distraction.

Every child, every time
Each child has their own ways of coping. Your care team will ask what works best for your child. Preschoolers have big imaginations. This may make the hospital unpredictable or scary. Distraction, preparation, the presence of a caregiver, and play can help reduce pain and provide comfort. Here are a few techniques that may help your preschooler:

• Stress ball or squishy toy
• Deep breaths
• Fun or educational videos or iPad games
• Interactive toys
• Books
• Validating the child’s feelings

Comfort positioning

• Sit by themselves, in a caregiver’s lap, next to a caregiver on the bed, or in a chest-to-chest hugging position with a caregiver
• Offer to hold hands
• Avoid lying flat or being held down, with some exceptions

One primary voice

• Create a calm environment
  • Hushed tone of voice
  • One main voice speaking to the child
• Soothing music or sound machine

Reduce pain

• Numbing cream
• Cold spray Note: Cold spray is not recommended for children under age 4.
• Buzzy® (device that uses vibration to distract from pain)
• J-tip (needle-free device that gives numbing medicine) Note: This needle-free device makes a sound when activated. If using this method, we suggest that you let your child know what to expect and use noise-canceling headphones and distraction.

Every child, every time
Each child has their own ways of coping. Your care team will ask what works best for your child. School-age children want to know what to expect. Distraction, preparation, the presence of a caregiver, and play can help reduce pain and provide comfort. Here are a few techniques that may help your school-age child:

• Deep breaths
• Stress ball/squishy toy/fidgets
• Books
• I Spy game
• Virtual reality
• Diversional videos or iPad games

Comfort positioning

• Choice to sit in the child’s preferred position (with caregiver present if preferred)
• Respect modesty by offering privacy
• Offer to hold hands
• Avoid lying flat or being held down, with some exceptions

One primary voice

• One main voice speaking to the preteen
• Careful choice of music
• Relaxing sounds and meditation

Reduce pain

• Numbing cream
• Cold spray
• Buzzy® (device that uses vibration to distract from pain)
• J-tip (needle-free device that gives numbing medicine) Note: This needle-free device makes a sound when activated. If using this method, we suggest that you let your preteen know what to expect.

Every child, every time
Each preteen has unique ways of coping. Your care team will ask what works best for your child. Preteens can tell us what can help. Distraction, preparation, and social support can help reduce pain and promote coping. Here are a few techniques that may help your preteen:

• Simple explanation of what to expect
• Diversional videos or iPad games
• Virtual reality
• Engaging conversation
• Deep breaths
• Stress ball or fidgets

Comfort positioning

• Choice to sit in the teen’s preferred position (with caregiver present if preferred)
• Respect modesty by offering privacy
• Offer to hold hands
• Avoid lying flat or being held down, with some exceptions

One primary voice

• One main voice speaking to the teen
• Careful choice of music
• Relaxing sounds and meditation

Reduce pain

• Numbing cream
• Cold spray
• Buzzy® (device that uses vibration to distract from pain)
• J-tip (needle-free device that gives numbing medicine) Note: This needle-free device makes a sound when activated. If using this method, we suggest that you let your teen know what to expect.

Every child, every time
Each teen has unique ways of coping. St. Jude staff will ask what works best for you and your teen. Teens can tell us what can help. Distraction, preparation, and social support can help reduce pain and promote coping. Here are a few techniques that may help your teen:

• Deep breaths
• Simple explanation of what to expect
• Diversional videos or iPad games
• Virtual reality
• Engaging conversation
• Stress ball or fidgets