Doctor Visits: Prep + Practice
Even though my toddlers are familiar with doctor’s offices (they visit me at work, play with my medical equipment & understand what happens at doctor visits), they still get really nervous before their own check ups. And even though I’ve seen countless kids get shots in my work as a pediatrician, I still cry when my own children receive vaccines. Every time.
Practice before the visit really helps toddlers with successful doctor visits. If they understand what is going to happen, it lessens the unknown and helps them to feel more comfortable in a new situation.
This is where play comes in! Developmentally, toddlers learn best through play. Their brains are wired to understand concrete situations based on what they have seen and experienced. Toddlers also learn best by using their senses – you know how they reach out to touch (or lick or bite:)) everything that they see? That’s how they learn, by experiencing the world through touch, smell, sight and sounds.
A Few Days before the Visit
Grab your little one’s favorite stuffed animal or doll. If you have a doctor or nurse kit, wonderful! If not, don’t worry. You can use a medication syringe from the pharmacy (or you may have one at home – they are often found in infant tylenol or other medication packaging), a cotton ball dipped in rubbing alcohol or cold water and band-aids.
You both can work together to examine your stuffed animal patient, checking her weight and height, ears and mouth, heart and belly. Let your toddler guide this part of the play with her patient, so that she feels that control. As I’m sure you well know, children this age love control! Then practice some comfort positions with the stuffed animal (see my previous post on Comfort Positions).
If your little one will need vaccines, you can start by pretending to be the doctor giving the stuffed animal a shot. First, wipe it clean with the cotton ball. Then give the shot and put on a band-aid. Practice a simple script to narrate the process and plan to repeat this during the real visit (see below). You can say “Here is your shot. Let’s clean first – clean, clean, clean! Quick pinch. All done! Great job!”
Now let your toddler touch all of those supplies and practice the same sequence. If it’s too much for them to practice the whole thing, just have them explore the materials – e.g. feeling the cold cotton ball and smelling the rubbing alcohol (this is often a really strong smell for toddlers and can evoke visceral reactions prior to their shots if they haven’t experienced it before). Lastly, have them choose which band-aid they would like to put on their patient when it’s all done. This will help them to feel some control during the process.
The Day of the Visit
Plan to bring a comfort item for your toddler – a lovey, a favorite toy, anything that they choose. You can ask your toddler if they would like to bring their own band-aid (they can choose that too!) for the shot.
Once you start the visit, get your toddler comfortably in a comfort position. Feel free to let the doctor know that you would like to do as much of the visit with your little one in a comfort position as possible and then put them on the table for the rest of their exam. I often examine my patients’ eyes, ears, throat, heart and lungs while they are comfortably in their caregiver’s lap and then move them to the table for their abdomen and the remainder of their exam. This allows them to feel safe and often allows me to get a much better physical exam. Some children prefer to sit up on the table alone, but for those who feel nervous, this helps us to develop rapport and trust as I examine them. Talk with your doctor to see how this would work best during your visit.
During the visit, narrate the actions that you did during your pretend visit. For example, “Oh look, the doctor is checking your ears just like you checked Fuzzy’s ears during our check up!” When it is time for shots, you can ask the nurse to do a pretend first shot on your little one’s stuffed animal, like you did during your practice play. Keep them in a comfort position (again, work with your doctor and staff to see how this will work best during the vaccine administration) and narrate the process calmly and confidently just like you did in your practice play (even if your little one is upset or cries). Familiarity helps toddlers to feel secure. Even if it seems like they are not paying attention, they will remember the sequence that you have practiced. They will feel some control by knowing the process and by being able to have a role in guiding some parts of it. Most importantly, they will feel (physically and emotionally) connected to you through the whole process, which will help them to get through a tough situation knowing that they are safe!
At the end of the visit, congratulate your little one and yourself for a job well done!
Warmly, Anjuli
Photo by Isaac Quesada on Unsplash
