5 Not-So-Fun Health Firsts

Some childhood milestones are looked forward to with great anticipation, others not so much. Most kiddos will experience at least a few of these painful firsts. Here are some ideas to help take the sting out.

1. The Blood Draw 

Sooner or later, every child will go through the drama of having blood drawn from a vein in the arm. Yes, the needle pinches and the fat rubber tourniquet can be uncomfortable, but there are techniques that will make it less of an ordeal.

Explain and practice at home.  Many kids are as scared by the idea of having blood taken as they are by the experience itself. So if you have advance notice, discuss why it’s needed in a way that’s understandable and funny. Reassure that while it might look like a lot, it’s really only a tiny bit of blood that’s taken, and kiddo’s own body will replace it quickly. Tie a thick rubber band around the upper arm (it helps to do it to yourself or a favorite toy at the same time) and poke gently with a toothpick or other clean object to imitate the feeling of the needle prick. Offer a sense of mastery.

Order up a topical anesthetic. Most pediatricians and labs that treat children have them available, but some need to be applied ahead of time, so ask your doc at the same time (s)he orders the test.

Use distraction. Bring along a favorite doll or Teddy and “draw his blood” (without the needle, of course) while the tech is drawing munchkin’s. Have your child talk you through each step and soon you’ll both be finished.

Offer a reward. Create a fun tradition that will take you through years of blood draws and other unpleasant must-dos for your kids. Tailor it to your family’s preferences, but don’t go overboard. Our favorite is a trip to the library or bookstore for a book of choice, complete with immediate snuggle ‘n story time if desired.

2. Swallowing a Pill

This is a life skill that must be learned sooner or later and some kids are naturals, while others will gag and sputter well into their teens.

Don’t place the tablet or capsule too far back. It’s tempting to try to stick it half way down the esophagus to get a head start, but that technique pretty much guarantees it’ll gag its way back up.

Give a sip – then the pill – then more sips. Making the oropharynx wet and slippery to begin with will help it slide down.

Take small steps. Start small and cut the pill into multiple pieces if you need to. Some meds are smaller than others, for example Claritin and Benadryl are both small and make good starter swallows if your child happens to take those. Don’t try to start with a big horse pill or your child’s anxiety may sabotage the effort.

If all else fails, don’t forget the chocolate pudding. It’s nice and slimy, making a better vehicle for the swallow than water for some kiddos. Depending on your child, you can bury the pill in a big glob of pudding on a spoon, or place it on the tongue and chase it with a mouthful of the stuff.

3. Stitches

… are never fun. And the blood and gore that came first can make them that much scarier. A cut that’s more than a quarter-inch deep (especially on the face or head) or gapes open usually needs stitches, but the good news is that more and more docs are now using glue instead, especially for smaller lacerations.

Ask for topical anesthetic before the needle looms. Your kiddo will get an injection of local anesthetic like lidocaine for the actual stitching, but why make him suffer through that pain if he doesn’t have to?

Be honest about the procedure, but leave the drama at home. There’s a big difference between giving the facts about what’s to come and sharing your anxiety. Keep your tone neutral and leave the instructions to the professionals. If the staff says to keep that hand still, kiddo is likely to take it seriously. If you say it he’ll hear the terror in your voice and go to that scary place.

Bring entertainment. The wait at the emergency room may be long or longer, and diversion helps stave off a meltdown. This is one of those times we say let ’em hold on to that iPad or whatever gizmo for as long as possible. That yawning hole may be forgotten in the face of unlimited episodes of The Simpsons.

Mention the Stitch Fairy. Let them look forward to one of our favorite tricks of stitch removal. Save each tiny snippet of thread in a piece of clean gauze when the time comes and offer a monetary prize for each. A wound requiring 8 stitches may be worth a dollar a stitch if that’s what it takes to smooth the road.

4. A Broken Bone

Some kiddos consider it a badge of honor, while others are terrified of something they imagine is like shattered glass. If the bone is protruding (called a compound fracture) all bets are off. Wrap the limb in a clean towel and it’s 911 time, but a simple fracture can be handled with much less fuss and a way cool cast.

Ask for pain relief (his, not yours) right away. Broken bones hurt, but kiddo doesn’t have to. Sedation will be used if manipulation of the limb is needed to get the bone ends into alignment.

Request an explanation of the xray. Kids (and grown-ups) tend to be distracted and interested when they can see the evidence in black and white. It takes the mystery and some of the fear away.

Insist on a cool cast color. Black makes it hard to collect all those comments and signatures, but there are loads of other snazzy choices. Choose one.

5. Overnight in the Hospital

This is the big trauma producer. Being in a scary place with strangers poking and prodding would be upsetting to most of us, especially when they’re all so much bigger.

Prepare. Pick up a few of those picture books (Elmo Goes to the Hospital is a favorite) and read them early and often if you have advance notice. Take the tour designed for kids; most hospitals offer one. Talk about friends who’ve been in the hospital. Demystify it.

Empower your child by giving choices whenever possible.  Which pillow do we bring from home? Which pajamas? Let him choose between sitting on your lap or squeezing your hand for the IV stick. Left or right arm?

Stick like glue. Stay by your child’s side whenever and as long as possible. Short of the operating room or MRI scanner itself, you shouldn’t ever be forced to leave your child. If you’re asked to step out insist on an explanation that makes sense to you. Your presence will always make kiddo feel safe. Remember: he’s your child, not theirs.

 

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Rachel Zahn, MD is a pediatrician turned health writer who had three kids during medical school and pediatric training—crazy, huh?


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