By Melodie Veldhuizen

Doctors who have just started a practice usually have little experience of handling small children in the consulting room. Two experienced doctors provide guidelines, supplemented by guidelines from the literature. Parents are given tips on how to prepare their children to make the visit to the doctor easier for the chid, the parents and the doctor.

The consulting room, equipment, appearance and attitude

• Create a child-friendly corner in the waiting room and consulting room with, for instance, a small table with little chairs, books, colouring pictures and crayons, or put colourful cushions on the floor with a container of toys. (During the Covid pandemic this is not recommended.)
• Use child-friendly examination instruments. Smaller versions of these as well as coloured stethoscopes are available. Or make a small “dress” for a stethoscope and give her a name, for instance “Mary”. There are pharmaceutical companies who make throat sticks with a lollipop at one end.
• Keep a container with lollipops or chocolates (or balloons) on your desk to calm the child before or after the examination or procedure. You could also give the child a throat stick with a face drawn on it, a syringe or (unused) glove that can be inflated like a balloon as a reward for good behaviour to take home.
• Preferably do not wear a white coat.
• Smaller children can sit on Mom’s lap where they feel comfortable and safe.
• A bigger child can lie on the examination table, with Mom in sight, or close enough to hold her hand.
• Let the child hold a favourite toy or comforter to put her at ease.
• Allow the child to touch the examination instruments so that she can realise that they hold no threat. While busy with the examination, explain calmly what you are doing and why you are doing it and assure her that you are not going to hurt her and that you want to let her feel well again.
• Be sympathetic, friendly and calm and put her at ease. Show that you care and guard against aloofness. The child must see you as a friend and not as an enemy or threat.
• Keep instruments that can upset the child (a syringe, for instance} out of sight. If the child is scared and won’t allow you to examine her, take turns to, for example, first look into Mom’s throat and then in his.
• Do not criticise, even if you suspect that the disorder or injury was caused through negligence.
• In the case of children who can communicate well, you can ask exactly where it hurts and whether it is uncomfortable if you push down on a specific area. And rather let the parent give the important medical facts (for example, when did she last urinate, did she eat something that made her nauseous, what she is allergic to).
• Let the child play quietly aside while you discuss the diagnosis and further procedures with the parents.

This is how parents can help

There are a few things parents can do to prepare the child for the visit to the doctor (especially the first time).

• Play doctor-doctor with the child. Get a toy medical kit. Explain to her what each instrument is used for. You must be the doctor who examines her and then let her in turn examine her teddies or dolls.
• There are cute story books about “I am going to the doctor” that you can read to your child to prepare her.
• Tell her a few days beforehand that you are going to see the doctor. Explain as well as possible what is going to happen. For instance, be honest about the injection that will perhaps hurt a bit.
• In an emergency, for instance when she falls and is seriously hurt, there won’t be time for preparation, but calm her down and assure her that the doctor is going to help her.
• Most small children are afraid that their parents are simply going to “disappear”. Asssure her that you will stay with her all the time.
• If possible at all, try to make an appointment for a time when the child is not going to be tired or hungry.
• Stay calm, even if you are anxious and upset. It complicates the doctor’s job if he also has to calm an anxious, hysterical mother.
• Never threaten your child with the doctor, for instance by saying: “If you don’t stop crying/if you are naughty the doctor is going to give you an injection and then you will get medicine to become good again.” This will only make the child suspicious of the doctor and refuse to cooperate.
• Try not to take all the children along if only one child is sick or because you suspect that the brother or sister has also become infected. Sometimes the “healthy” children turn the examination room upside down.
• Try not to take your child to a different doctor every time. With regular visits to the same doctor a relationship of trust will develop and the child will be more amenable to go along and cooperate.

Sources

AAFP. https://www.aafp.org/afp/2018/0915/p347.html

Chron. https://work.chron.com/equipment-pediatricians-use-9775.html

GP Training. https://www.gp-training.net/communication-skills/specific-scenarios/communicating-with-children/

Health Link. https://www.healthlinkbc.ca/health-topics/tw9822

Kids Health. https://kidshealth.org/en/parents/dr-visits.html