Practicing for the Doctor: It just might work!

Lilah's 12 month doctor's appointment was a bit of a challenge. She started crying as soon as we put her up on the table for the nurse to weigh and measure her and take her temperature. The crying continued and then increased when it came time for the needles and she didn't really stop until we left the office.

Needless to say, I was very motivated to do what I could to prevent the situation from happening again. The last thing I want is for my daughter to develop a fear and hatred for the doctor. I asked around for some advice and a friend suggested buying a book about visiting the doctor.

We went out the next day and bought a book about going to the doctor and started reading it on a regular basis. A few weeks later, Lilah's grandparents bought her a doctor's kit and we stared playing with kit while reading the book. Lilah quickly came to understand the names for the instruments and how to use them. We played with a stethoscope, thermometer, needle, and ear/eye/throat light to name but a few. We had also put a height chart on the wall and talked about it as we went through the story as well (even though the doctor does not yet measure her height on a chart).

Our 15 month appointment we much more successful that the previous visit. There were still a few tears and some fussing, but significantly less than before. We took the book and doctor's kit with us and pulled out the instruments and looked at the appropriate pages of the book before each step of the appointment. I really can't say for sure whether it was the 'practice' or simply that Lilah was having a better day and/or had matured since the last appointment that made the visit better. In my opinion, it doesn't really matter. Even if the book and the kit made no difference, we had a lot of fun playing with it (and still do) and I am positive that Lilah learned a thing or two along the way.

Some tips for making your appointments more successful:

1) Talk about the upcoming appointment the day before and/or on the day of the visit (talking about it any earlier could actually increase anxiety).

2) Read a book about what to expect at the visit.

3) Act out what to expect using a doll and/or a doctor's kit.

4) Let your child take something special to the appointment (toy/blanket) for comfort.

5) Ask the doctor to 'examine' you or your child's doll before examining your child.

6) Talk about the fun parts of the visit (toys in the waiting room, sticker/book prizes).

7) Be honest about the hard parts of the visit (ie. needles). Tell your child that it will hurt for a few seconds.

8) Distract your child while the needles are being given.

9) Provide a lot of praise after the appointment!

Good luck!

Immunizations...A Necessary Discomfort

Next week, Lilah will be getting her 6 month immunizations. It seems like so long ago that I was stressing out about her first round of immunizations at 2 months. I was terrified that they would hurt her, she would cry, she would have some kind of reaction, she would develop a fever, she wouldn't sleep, she wouldn't eat. You name it, I was worried about it.

Luckily, none of the aforementioned events happened. She was a trooper. She did cry a little a few seconds after the needles went in, but the tears didn't last long. Even though she didn't cry for long, I still nursed her right after her 2 and 4 month shots just to comfort her.

Several people had told us that we should give her infant pain medication before hand to head off any pain and/or fever that might develop. We did this for her 2 month immunizations, however, one of the first things our doctor asked us at her appointment was whether we had given her anything.

Why?

Well, recent research suggests that the immune response that infants have to a vaccine is decreased by pain medication. Our doctor noted that infants should not be given pain medication unless they absolutely need it. We did end up giving her another dose about 4 hours after she received the immunizations because she was truly in pain. We avoided giving her pain medication before her next appointment, but we did give her a dose about 4 hours afterward again when she started to exhibit signs that she was in pain. One dose afterward was all she needed on both occasions.

It is pretty difficult to stand there and watch needles being stuck into your tiny little baby (especially when you have to help hold them still). It gets a little easier as they get older, but they also become more aware of what is going on which is equally hard to deal with. Up to this point, nursing right after has seemed to do the trick and your doctor should be more than accommodating about letting you stay in the room afterward for a few minutes if you would like to nurse.

As we currently live in the U.S., we have been following the immunization schedule here (which is fairly similar to the one in Canada). This requires that Lilah be given 3 injections and one oral vaccine at 2, 4 and 6 months of age. We decided that we didn't want her to be given 3 needles at the same time so we opted to request a follow-up visit about a week later for her to receive 1 of the vaccines. I am not sure if this has contributed to the fact that she has had very little trouble with her immunizations, but it certainly makes me feel better. We have also never had to give her pain medication after these follow-up visits (when she only received one injection) which is a bonus as I would rather not give her medication of any kind unless it is absolutely necessary. Your doctor should be more than happy to accommodate any special requests you may have regarding immunizations (as long as they are within reason). Opting not to have your child vaccinated, for example, does not fall under the "reasonable request" category.

The idea that vaccinations cause autism spectrum disorders was the driving force behind a large group of parents deciding not to immunize their children (which in turn led to outbreaks of measles and mumps). This claim was made in a 1998 paper in The Lancet (a British medical journal). It was later discovered that the author of the paper manipulated evidence and had broken ethical codes. This paper has since been retracted and the author found guilty of professional misconduct (May 2010).

Needless to say, going for the third round of immunizations is old hat. I must say though, I am very happy we don't have to have any more needles until Lilah is a year old!