Recently I got an email from a reader about how to help her child manage her anxiety of going to the hospital, doctor, or dentist. Her daughter is only 21 months old, but has spent 34 weeks of her life in the hospital. Within that time she has been exposed to numerous procedures without sedation including colonoscopies, NJ tube placements, and endoscopies of her throat. Even though her child is young, she has developed a fear of doctors, nurses, and any health professional. This is a precarious place for any parent that has a child that is medically complex. Our children need to be seen frequently, and it’s imperative that they develop healthy relationships with the medical staff that are on their team. Even Healthy children need to develop healthy relationships with their pediatricians. It’s important to find strategies to help your child cope.
When I look back on my own journey with my son, I do recall a time where he was petrified of doctors. Blood draws required multiple people in the room, and I would have to straddle him and pin him back. He would scream when needles came out or if we even discussed that he needed an injection. I have made some changes for when he and I go to the hospital now, and it’s all been done to limit his anxiety and stress during his time in the clinic or the hospital.
Role Play Medical Scenarios with Your Child
Early on we were given a packet of medical equipment from the Child life department at our local Children’s hospital. The best advice they ever gave me was to allow him to play with the medical equipment, and to do role play or imaginary play with his toys. We started doing games at night where we gave his stuffed animals shots, checked their temperatures, fed their tummies (for tube fed children), vented their tummies with sound effects, and gave his animals nebulizer or inhaler treatments. Often times when we were done, we would let our son put a band-aid on the “owie” of his stuffed toy. Soon it became a game that he wanted to do every night. He started enjoying making his stuffed animals feel all better. We would talk through the games and explain to him that all of this is to help them feel better and it’s exactly what the doctors and nurses are trying to do with him. He began associating offices and hospitals with places that make him feel better instead of places that scare him.
Comfort Your Child During Check-Ups and Tests
My son gets horrible anxiety about going up on the table or the bed of the clinic. He knows all too well that being on the table or bed will mean he’s going to be poked and prodded. If a doctor even asks him to go on the bed, he will break out in tears and scream. We have managed to find ways to be with him, hold him, and comfort him in every check up. It can take a bit of creativity on the end of the parent, but most physicians welcome your feedback. For check-ups, my son always sits on my lap when doctors need to listen to his lungs, heart and abdomen. If he needs a scan like an echocardiogram, x-ray, swallow study, or ultrasound I always got in the room with him. If permitted I will lay down with him and have him lay on top of me for the ultrasounds. For X-Rays or anything using radiation, I always stand at his head and gently touch his face or hold his hands so he knows I’m there. Having me there always reduces his stress and anxiety.
Limit Discussion of the Appointment
Children with anxiety often will hyper focus on an event if they know it’s coming up. I know this because I was a child with anxiety. My son is no different. Initially we use to tell him well ahead of time to prepare him for appointments, surgeries or admissions. Now we keep things very simple. The less he knows ahead of time the less time he has to build up any anxiety about the event. We typically tell him the day of what we are going to be doing. I don’t want to give him the time to worry about what is coming up. He is less anxious when he has less time to process what will happen. We also do not discuss in detail what will happen at the appointment. I do not tell him he will get any shots, or if there will be any blood draws. I want him walking into the appointment feeling confident and without fear.
For big appointments that I know will be very challenging for him, I always offer him a reward. He can pick whatever he wants within reason as long as he is a good boy at the visit. Many of his doctors take blood, run labs, take x-rays and do ultrasounds. All of these can induce a lot of stress in him. When we get to appointments, I let him know that if he does a good job he can pick out a toy at the store after the visit. Bribery while not always the best method can be very effective to manage challenging appointments. He knows that he needs to behave if he wants the toy, and generally offering an incentive helps him cope.
Allow Your Child To Bring Their Favorite Toys or Electronics
Since we go to the hospital a lot, and my son is medically fragile we try to reduce the exposure of toys at the clinic. Before every appointment, I allow him to pick 2 or 3 toys he wants to hold on to or play with while he’s there. In the early days, we often brought his favorite blankets and stuffed animals. As he’s grown he chooses his favorite toy of the day. We have also found that allowing him to watch his favorite cartoons, shows, or listening to music can help distract his attention. During check-ups, blood draws, or anytime he may be poked or prodded we allow him to watch his iPad if permitted. He’s managed to sit through many echocardiograms without a peep as long as he could watch his favorite show. Having the toys allows him to be busy while we wait for the doctors and nurses, and keeps us safe from using toys that may have been touched by other sick children.
Managing anxiety and fear of the doctor can be very difficult for most families. When your child is medically complex, it can be imperative to find ways to calm their fears. Implementing the above strategies will definitely help your child better prepare for their visits, have less fear of their appointments, and feel good about themselves for getting through an appointment with no tears.