Box 1: Content of active and placebo educational videos

Active^*	Placebo^*
A: Assess your own stress	A: Act in your child’s best interest
Take a few belly breathes while holding your infant, and the baby will feel the rhythmic breathing, which is calming	Make decisions that you think are best based on your child
B: Belly breathing	B: Be aware that needles are distressing
Take a slow deep breath through your nose for 3 seconds, expanding your belly and not your chest Then breathe out through your mouth for 3 seconds; each time, count 3 seconds Repeat this 3 times while cuddling your baby	Needles are distressing for adults, so of course they are distressing for your child
C: Cuddle and calmly talk to your baby	C: Carry out what you think is best for your infant
Babies should always be held closely before, during and after the needle If the needle is going in the your infant’s arm (or thigh), hold the arm (or thigh) firmly but gently, so the baby won’t move it Calmly talk to your child after the needle Let your child know you’re there for them, bring them closer, and talk about anything but the needle or pain Many parents find it easiest to talk about what they will do when they leave the office The baby may not understand the words, but they understand your tone
D: Distract your baby	D: Do your best to help your child
Distract your baby and take their attention away from the pain Distraction can only occur once the infant is ready to be distracted; this is typically between 20 seconds and 1 minute after the needle Trying to distract the child when they’re not ready to be distracted can cause more distress If the infant isn’t ready to be distracted, return to cuddling for a little longer

↵* Both videos included introductory comments about the epidemiology of vaccination pain. The placebo video included injection techniques used by health care professionals to reduce pain (i.e., order and speed of injections).