Chris, What size needles are they using? That might have something to do with it also. We give my son the shots every single night. We use the ultra fine needles and the Emla. We didn't use the Emla in the very beginning because they said it might not make a difference but I decided to do it anyway. I just gave my son his evening shot and I swear to God he said "Ah, Emma cream - My herooooooo". I know it is hard to believe but it is true. Perhaps he watches too much TV. So far, the nurses at the clinic have asked us to continue using it. He would scream so loudly when they didn't use it they would have to shut the doors so that he wouldn't scare the other children. He now marches in like a little soldier and jumps up on the table. He points to the spot that has the Emla cream on it and watches as they stick him. He doesn't make a peep. The two hospitals in New York we go to make it a practice to use the Emla cream regularly. They told us to pull over when we are about 20 - 30 minutes away and apply it to a broad area. They then go about doing the blood draw. This was the case most recently during a 2 hour blood draw at Cornell Hospital. He didn't complain once. Perhaps it is an individual thing. Everyone responds differently to medications, could it be that we finally got lucky? Say it isn't so! I would recommend that everyone try it at least once and see how it goes. For us, at least up until this very moment, it has made all the difference in the world. I hope it never changes.