When I decided to become a doctor, I knew right away that I'd go into pediatrics. Working with children is both a privilege and a challenge. The privilege comes from parents allowing me to take care of their children. The challenge is making office visits as pleasant as possible.
The way you talk to your child about doctors' visits is important. Kids are sensitive to their parent's emotional state, so a calm and reassuring tone is important.
Avoid the temptation to tell your child something won't hurt. The reason for this is because people react to situations differently. For example, even though throat cultures don't bother most adults, they can be very distressing for kids. It's better to say something may hurt, but add that it will be over quickly and you'll be there to help.
- If possible, don't schedule a visit during your child's naptime. This makes them cranky and harder to examine.
- Bring a bottle or snack to the office in case your child gets hungry.
- Although pediatric offices have lots of reading material, take along one of your child's favorite books or toys.
- Try not to plan another activity right after the visit because your appointment may last longer than anticipated.
- Bring as few children to the office as possible. The more kids in tow, the more difficult it will be for you to help your child and pay attention to what the doctor has to say.
- If you are new to an area, make a "get acquainted" visit with the doctor. This is a brief visit where the doctor can meet your child in an informal way that does not involve an examination.
- If your child is worried, read a book about visiting the doctor or have play session where your child can pretend to be the doctor.
- Bring a love object to the appointment. Stuffed animals are not only comforting, but they foster communication between doctor and child.
- Bring a toy doctor's kit so your child can "examine" the doctor.
What To Say About Shots
Parents often ask me if they should tell children about shots before they arrive. The answer depends on the nature of the visit. If your child has a specific appointment for a shot, you should tell him before you leave home. Although this may make your child anxious, it gives him a chance to prepare for the procedure.
If your child is having a checkup, tell him you don't know if he's getting a shot. The reason for this is because immunization schedules change. Therefore, it's hard to know for sure if a shot will be part of the visit. The same thing holds for blood tests.
Helping Your Child With Shots
Distraction is the most effective technique to help young children deal with needle-related pain. Older kids also have success by giving themselves positive messages such as, "I can do this."
Once a child knows he's getting a shot, he will often ask questions about when it's coming and what it will feel like. A calm and direct approach works best. It also helps to give choices. He can pick which arm gets the shot and what type of bandage to use.
We have a policy in my office called "tag-team shots." If a child needs more than one immunization, two nurses administer the shots simultaneously. This reduces the anxiety of getting the second shot.
- Young infants: maintain eye contact, smile and talk to the baby, sing songs.
- Older infants and toddlers: distract the child with toys, songs, a story, car keys, blowing bubbles, finger puppets or looking at interesting objects in the room.
- Preschoolers and school-aged children: same as toddlers plus look at family pictures, use electronic devices like a cell phone or talk to the child during the shot.
- Older children who are anxious about needles can request a topical anesthetic to reduce pain. This is more effective for blood tests than shots and takes 30 minutes to work.
What To Do If Your Child Won't Cooperate
Some children are unable to cooperate with shots or blood tests no matter what you do. If this happens, please realize that fear is the motivating factor. Never tell a child he is being a baby because this does not work and only makes him feel worse. Instead of getting upset, some children will stall by asking repeatedly what the shot will feel like. Or they may say, "Just give me a minute, and I'll be ready." In some cases, the minute never ends.
There is a fine line between giving a child a chance to voice his concerns and letting his fears go on forever. Trust your instincts if you think you can convince him to cooperate because this would be best for everyone. However, there comes a time when a child needs you to be strong for him. In this instance, you should calmly hold him for the shot so the stress will be over rather than letting it drag on. If you are unable hold your child, a nurse can do it for you.
After the Shot
Some children cry despite your attempts to ease their pain and anxiety. This is normal. In my office, I tell children it's okay to cry, but we need them to hold still.
Once the shot is ove,r you can compliment him on getting through the procedure. Other things that help include hugs and kisses, stickers and lollipops. It may also help if your child gets to do something special after the visit such as a trip to the park or extra TV/computer time.