Using EMLA or ELA-max cream really works and takes away my three year old daughter’s anxiety and pain when changing her Insuflon catheter, but the package insert warnings scare me. Do you have any information on the safety of using EMLA or ELA-max cream every four days in a three year old? Is it worth the risk?

ELA-Max is now actually an over-the-counter medication. In regards to the package insert of this or EMLA, remember that every medication offers known (and not-yet known) concerns. You must weight the real benefit with the potential disadvantages. Ela-max works faster than EMLA and does not require the occlusive dressing. I think that any family should work towards the goal of not-requiring the topical anesthetic, knowing that some children require it if but for no other reason than a security blanket.

Other tricks that you may try:

Numb the insertion site with a cold sugar-free popsicle for several minutes. After the insertion is done, the popsicle is the reward.
I have one family who we used the spray on “freezing” material that pro-athletes use when injured. It is called ‘ethyl chloride’ (available by prescription from your pharmacy). It worked better than EMLA for her. A quick spray, “numbs” right away, and now she uses nothing.
If there is a lot of pain, talk with your diabetes team educators about using a different insertion cannula.

DS

[Editor’s comment: EMLA is currently not on the market for a limited time. See EMLA Cream to be Taken Off the Market in the United States.

SS]