This blog was written to help you learn some ways to deal with difficulties or fears your infant/child may have about medical visits. Many of the suggested strategies, techniques and distractions discussed may already be familiar. It is important to remember to use them at the time your infant/child is afraid or upset.
It is difficult to learn the techniques described in this blog at the moment your infant/child encounters an uncomfortable situation. Research has shown that children who are appropriately prepared and given an opportunity to rehearse coping skills, demonstrated less emotional distress, greater cooperation and better adjustment in general. If these techniques are learned at an early age, then a child’s coping skills could ease difficult moments at various times. These coping strategies can be used to help reduce anxiety and discomfort for your child. I recommend spending some quiet time with your child each day teaching her some of the techniques in this blog.
Preparation and Medical Play (15 months through all ages)
Children benefit by being prepared for visits to the doctor, dentist or hospital.The following are some suggestions to help prepare your child:
- Prepare yourself first. You can ask your child’s doctor or dentist for more specific information.
- Choose a quiet time to talk to your child. If you are calm and use a relaxed voice it will help your child to be relaxed.
- Your know your child best of all. Help your child get ready by talking with her.
- Decide when to tell your child about an upcoming medical procedure or visit. It is recommended that toddlers and preschoolers usually cope best when told about a procedure or visit one to three days ahead of time.
- Consider telling your five or six year old child three to five days ahead of time.
- School-age children like to know about five to seven days ahead of time.
- Adolescents should be informed as soon as possible.
- Offer your child honest, sensitive and developmentally appropriate information that she can understand.
- Explain the reason for the visit or procedure .
- Prepare your child for what will happen.
- Ask your child what might “help” during the procedure or hospital visit.
If your child goes to the hospital, she will feel better learning about the hospital and getting ready for the new experiences. The “clingy” infant arrives around 10 months of age, and parents know when they see it. Suddenly, leaving the child’s line of sight causes the little one great distress – thanks in part to the child’s undeveloped sense of time and lack of experience with a parent’s absence. Fortunately, separation anxiety passes with time. It’s a normal stage of development for most children, usually ending by the last half of the second year.
As the toddler learns that Mommy and Daddy keep coming back after they leave, the fear subsides and the child’s confidence builds. It’s getting from here to there that can make for some trying moments, and often some tender ones, as well. This fear in the child is called separation anxiety, and it is a normal, healthy part of growing up. It usually peaks between 10 and 18 months, fading by the end of the second year. During this time, your child is learning that you won’t always be right there at her side. That can be a very painful lesson. But your child is also benefiting from these first steps of relative independence, and learning how to use the memory of routine to reassure herself emotionally.
As a child grows, those fears change. The fears of body changes, pain, appearance and privacy deepens as the child gets older. Many hospitals offer a special program with hands-on activities for children, where they can see and explore real medical equipment. Ask your child’s doctor for this information. Pre-admission programs are usually offered by the Child Life Department at your hospital or through the Department of Pediatrics.
For a hospital visit, you can pack some special things to have from home. Most children pack a few favorite things like pajamas, books, games or a special toy. Some children like to bring pictures from home or their own blanket or pillow. Some tests and procedures may hurt in the hospital. Use the techniques in this booklet to help your child during difficult times. Ask to speak to a child life specialist or a nurse. She will help your child during her hospitalization.
Comforting Positions (Infancy through pre-school years)
You are the best source of comfort for your child. Have your infant/child sit on your lap (chest to chest, sideways, or back to chest). This will help your child stay calm. You can practice hugging! Holding your infant in an upright position, or having your child sit on your lap will help her relax. Once infants learn to sit-up, they are so proud of this milestone that the act of making an infant or child lie down, may result in her crying or there being a struggle to get up. Physical touch provides security and warmth. Touching includes stroking, swaddling, holding, rocking and cuddling.
Positive Reinforcement (Six months through all ages)
Lavish your child with praise! Praise your child for helping and staying still. Praise your child for having finished the procedure even though she cries. Remember that crying is a way of coping for some children. Bring small rewards such as stickers and other treats.
Distraction (Six months through all ages)
Help your child focus on something other than the procedure. Read a pop-up book or storybook; sing a song; focus on a soothing, diversional object; look at photographs and talk to your child about them; blow on a pinwheel; recite familiar nursery rhymes; blow bubbles; practice counting or saying the alphabet. Older children may enjoy playing with electronic games or listening to music on earphones. Before the visit, help your child create a list of things she would like to use as a distraction.
Deep Breathing (Preschool through all ages)
Deep breathing will help your child to relax and slow her breathing rate. Help your child get into a comfortable position. Tell your child to breathe in deeply through her nose, count to three and blow out through her mouth. Encourage your child throughout the procedure. Breathe with your child and breathe slowly! Use illustrations your child will understand when explaining the breathing (for example, take a deep breath in like you are smelling flowers, count to three, blow out slowly as if you were blowing out lots of birthday candles). Use a pinwheel, breathe in, count to three and then blow on the pinwheel. Pinwheels are fun to watch and help your child relax .
Guided Imagery (Preschool through all ages)
Help your child see a picture in her mind of something or someone that she likes. Children do not have to close their eyes (many are afraid of “sneak attacks”), but it is helpful. Combine imagery with deep breathing. In a soothing voice, tell your child a story. Some things children like to imagine are stories of stars, rainbows, snowflakes, butterflies, animals, flowers, the beach or their favorite places. You could place your child on a magic carpet that flies over rivers, mountains and lakes and help her to visualize this in her mind.
The most important thing is the warmth, joy and closeness gained by your spending this quiet time with your child. The ideas outlined are examples of what you can do with your child. What you choose to do depends on you, the parent and the individual child. Good Luck!!
Note: Any suggestions, tips or techniques to help your child feel more comfortable during medical experiences are not intended to replace speaking to your child’s doctor or other health professional.
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Patricia Weiner, MS is presently an educational consultant and advocate for Children with Special Health Care Needs (CSHCN) and academic challenges. She works for The Making Headway Foundation, is a private consultant and faculty mentor for graduate students at Bank Street College of Education in New York. Over the past 35 years, she has worked as a special educator, child life specialist, health-education specialist and has been the administrator of several programs. She has presented nationally on education and child life, published articles and chapters in child life text books, and has received several awards for child advocacy for this population of children.
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