Certified Child Life Specialist and Piper+Enza contributor Lacey Holmquist dives in to pediatric x-rays and how you can make it a more comfortable, smooth experience for your child.

Hello! I’m excited to share how a Certified Child Life Specialist (CCLS) can make pediatric x-rays a less stressful experience for your child—and for you. As a CCLS, my role extends beyond just handling day-to-day interactions. I provide educational support, emotional reassurance, and practical strategies to families navigating medical procedures. Today, I’ll offer detailed insights and strategies to ensure your child remains still and comfortable during necessary imaging procedures like x-rays.

The importance of stillness in pediatric x-rays

Understanding why stillness is crucial during imaging procedures is essential. Clear images are critical for accurate diagnoses and minimizing unnecessary radiation exposure through repeat scans. Achieving this stillness can be challenging, especially with young children, who may feel anxious or uncomfortable in a new, clinical environment.

Traditional methods: The Pigg-O-Stat

The Pigg-O-Stat, an iconic device in pediatric x-rays, was invented in the early 1960s by Robert Pigg, a radiologic technologist. His invention was driven by the need to stabilize young patients during X-ray procedures without requiring physical restraint by medical staff or parents, which could often be distressing for the child. The device itself is cleverly designed to hold infants and toddlers securely in an upright position, ensuring that they remain still enough to produce clear, accurate diagnostic images. This is critical for reducing the need for repeat exposures to radiation. While the Pigg-O-Stat has proven effective in minimizing movement and thereby reducing radiation exposure, its appearance and function can be daunting. It’s normal for parents and children to feel unsettled seeing a child in such a device. Recognizing these concerns, let’s explore more comforting alternatives.

Comforting alternatives to the Pigg-O-Stat

To achieve the necessary stillness without the Pigg-O-Stat, there are some other gentler and effective strategies:

  • Swaddling for infants: Swaddling is particularly effective for newborns and young infants. By wrapping your baby snugly in a blanket, we mimic the security of the womb. This warmth and comfort minimize flailing and help maintain stillness.
  • Parental assistance: We encourage parental involvement whenever possible. You can hold your child during the scan, wearing a lead apron for radiation protection. This not only keeps your child calm but also reassures them with your presence.
  • Engagement and distraction: I employ various distraction techniques such as storytelling, singing, their favorite videos, or interactive toys. These methods engage your child’s attention, reduce movement, and make the experience less intimidating.
  • Comfort items: Allowing your child to hold a favorite toy, blanket, or book can provide significant comfort. Familiar items help soothe and distract, facilitating a smoother process.
Supporting non-verbal children through pediatric x-rays

Our approach needs to be particularly gentle and sensory-focused for non-verbal children, such as infants and young toddlers. Here’s how we tailor our support:

  • Sensory comfort and security: I use a calm, soothing tone, or gentle humming during the procedure, complemented by soft music or lullabies. This auditory comfort helps create a tranquil environment that distracts from clinical noises. Giving them a countdown, “I am going to count down to 1, I want you to freeze your body until I get to 1. 3….2….1 Wow! You did it!”
  • Visual engagement: Brightly colored toys, light-up items, bubbles, or mobiles catch the child’s eye, providing a focal point that reduces the sense of restraint, especially when secured in a device like the Pigg-O-Stat.
  • Tactile comfort: Touch is comforting, particularly for younger children. If feasible, I might lightly stroke the child’s hand or foot, or facilitate a comforting touch from a parent. Keeping a favorite blanket or stuffed animal within sight and reach also helps.
  • Some hospitals will also offer a gentler approach like  “feed-and-swaddle” for infants and young children for other types of imaging like CT Exams for obtaining pediatric imaging. This technique involves feeding the infant or young child prior to the procedure to ensure they are content and then swaddling them snugly in a blanket. This mimics the comforting environment of the womb, which can significantly calm and relax the child. The snugness of the swaddle restricts excessive movement, helping to keep the child still during the imaging process. This method not only facilitates the acquisition of clear images but also greatly reduces the child’s stress and discomfort by utilizing natural comfort cues. Feed and swaddle is particularly useful for ultrasound procedures, where the child’s comfort can directly impact the quality of the images obtained. It is widely favored in many healthcare settings for its simplicity and effectiveness in enhancing patient comfort and cooperation during pediatric imaging.
Additional considerations for pregnant parents

If you are pregnant and accompanying a toddler or baby to an urgent care visit, bring along a partner or a trusted adult whom your toddler is comfortable with. This person can enter the imaging room if you cannot, ensuring your child feels secure throughout the process.

If you can’t bring anyone else with you, walk with your child to the x-ray room. As you walk in, point out what you see and where you will be standing. Tell them the lead jacket is heavy, the x-ray is a camera and won’t be touching them. You can keep talking to them from behind the wall too so they can hear your voice.

Post-procedure care and minimizing trauma

Even when the use of the Pigg-O-Stat is inevitable, there are several actions you can take post-procedure to minimize potential trauma:

  • Debrief with your child: Use simple, reassuring language to explain what occurred and why it was necessary. Affirm that the procedure is over and they did a great job.
  • Physical comfort: Engage in comforting physical contact like cuddling or holding your child, reinforcing their sense of security.
  • Play! After the procedure, doing something your child enjoys, like playing a favorite game or reading together, can help shift their focus from the experience.
  • Monitor for distress: Be observant for any signs of distress or anxiety following the procedure. If concerns persist, consider seeking advice from a pediatric psychologist or a follow-up with a child life specialist.

Post-procedure role play 

Role play is a powerful tool that caretakers can use to help children process stressful medical experiences, such as pediatric x-rays. This method leverages play, a natural medium through which children understand the world and express their feelings. After a procedure, engaging in role play can help a child work through any anxiety or confusion they may have experienced.

In role play, a child can take on different roles, such as playing the doctor, the patient, or even the medical equipment itself. This allows them to re-enact the scenario on their terms, which can be incredibly empowering. Caretakers can facilitate this by providing toy medical kits or even creating simple props that mimic the equipment used, such as a cardboard box for an imaging machine. Through this play, children can gain a sense of control and understanding over what happened to them, reframing the experience in a context that feels safer and more manageable.

Additionally, caretakers can participate in the role play, guiding the narrative to include positive outcomes and reassuring interactions. This not only helps in normalizing the medical procedures but also in reinforcing that medical environments are safe places meant to help them. It’s also a valuable opportunity for caregivers to observe any lingering fears or misconceptions that children might express during play, providing clues on how to address these worries effectively in conversation and further play.

Overall, post-procedure role play is an empathetic approach that supports children’s emotional recovery and aids in their understanding of medical care, helping to mitigate the long-term impact of medical traumas.

Closing thoughts

As Certified Child Life Specialists, it’s our priority to ensure that medical procedures are not only successful in terms of health outcomes but also conducted in ways that respect and support the emotional needs of our young patients and their families. Your presence, involvement, and reassurance are incredibly powerful in helping your child navigate these moments. If you have any concerns or need further information, please don’t hesitate to ask. We are here to make this experience as positive and stress-free as possible for your child—and for you.

Lacey Holmquist is a Los Angeles-area Child Life Specialist and a Piper + Enza contributor.