You’re tired, frustrated and just need to lay down and take a nap and it's only 11am in the morning! Is this from lack of sleep? Too much to drink the night before? No! You just came back from an appointment at the pediatrician where your child clung to you nervously, whimpering at the site of the doctor, and then screamed during the exam and the shots that followed. If this sounds familiar then you are not alone. The good news is, there are a few things that may help your child. Some may seem like small things but even the smallest things can make a huge difference to a child trying to cope in a medical situation.
Its all about choices.
Going to the doctor can feel like the ultimate loss of control of your body, especially for a child. One of the simplest things to do is to offer the child choices whenever possible. For example, do they want to sit in mommy’s lap or on the exam table? Which ear do they want the doctor to look in first? Enlist the pediatrician to let your child be their helper for the exam and let the child have the feeling of driving the exam when possible. Example: “Timmy, I know you’ve been here lots of times and know just what we need to do during this exam. Where should we start first?” This can help make the doctor an ally during the exam, not an enemy, while giving the child a sense of control.
It's OK to cry.
Many times our temptation as a parent when a child cries and protests during an exam is to say “Don’t cry.” But why shouldn’t the child cry? Who truly enjoys getting a shot? Crying is a coping mechanism and one that we can work with, not against. The next time your child cries at an exam or when getting a shot let them know it's ok to cry if they need to but remind them that their job is to hold still while the doctor looks in their ears, their eyes, etc. Then when the doctor is done, validate and praise them by letting them know that you know that it was hard for them but they did a great job holding still for the doctor.
The dreaded shot.
We’ve all been there. Holding the child who is screaming about the shot that is coming. Initially this may seem like a situation in which you have no control. That shot is coming whether the child or parent likes it or not but even in this situation there are choices that can help the child, parent and doctor or nurse make it a less difficult experience. During a difficult procedure, the way a child is positioned can make a big difference in how in control a child feels. Most patients will do better when they are sitting up and using a position of comfort which can provide the child with the comfort and security they need while allowing for the doctor or nurse to administer the shot. Learn more about various positions to use here: http://www.childrensmercy.org/Patients_and_Families/Support_and_Services/Child_Life/Comfort_Positions/4.
Once the child is in a good position there are opportunities to provide distraction. The use of distraction techniques has been shown to help reduce anxiety in children and provide a more positive outcome in terms of cooperation from the child. A few options include: singing, blowing bubbles, blowing a pinwheel toy, squeezing someones hand, using controlled breathing and counting.
In later posts I will discuss medical play, which is a great way to prepare your child for a doctor visit and allows for the opportunity to practice coping skills ahead of time. If you are able to do even a few of the above mentioned techniques it can make a big difference. Perhaps most important of all is to remember that you know your child best so don’t be afraid to speak up! Being an advocate for your child allows you to have a voice and a choice in what is happening to your child, allowing for the medical experience to be a positive one.