Originally published in Motherly: Reducing medical trauma in kids is straightforward. So why aren’t we doing it?
“You’re just going to have to hold him down, miss,” the nurse informed me as my 4-year-old lay on the ground, refusing to get his flu shot and causing an inconvenient delay in the queue.
I sighed. This was not the first time I’d heard this in my 8+ years as a parent. In fact, many, many of today’s parents have been in this exact situation, and have their very own childhood memories of being restrained or held down during immunizations or other medical procedures.
According to the Centers for Disease Control and Prevention, as many as 2 in 3 children and 1 in 4 adults have strong fears around needles. Adults who have persistent fears of needles themselves may delay blood draws and vaccinations, not to mention hesitate to have their children vaccinated.
Just the other day, another mom shared with me that she has to look away when her kids get shots for fear of fainting in the exam room.
Does it really have to be this way? Are we destined to continue, generation after generation, to fear, avoid and fight these routine and necessary medical experiences, to hold on to traumatic memories that influence decisions around our (or our family’s) health?
The answer is no.
It’s time we prioritize reducing medical trauma in kids
Parents and medical providers alike want kids to have minimal trauma and anxiety associated with their medical experiences, whether they are as routine as a flu shot or dental filling, or as complex as a chemotherapy regimen. The problem is, they don’t always know how to go about it, or believe the trauma to be an unfortunate inevitability.
But the truth is, that with developmentally appropriate preparation and coping mechanisms, most children will have the capacity to face the aforementioned medical experiences with less fear, more confidence and, ultimately, a lot less trauma.
Child life specialists can help
Have you ever heard of the child life profession? Unless you have a child who has had surgery, been hospitalized or who has complex medical needs, the answer is probably no.
According to childlife.org, “certified Child Life Specialists help infants, children, youth and families cope with the stress and uncertainty of acute and chronic illness, injury, trauma, disability, loss and bereavement. They provide evidence-based, developmentally and psychologically appropriate interventions including therapeutic play, preparation for procedures, and education to reduce fear, anxiety, and pain.”
Moreover, “studies show that child life services result in cost savings, including reduced length of stay, decreased sedation needs, improved family satisfaction, and ratings of overall experience.” Additionally, the American Academy of Pediatrics (AAP) themselves support and endorse the profession and its important role in pediatric patient care.
Sounds incredible, right? Unfortunately, most pediatric patients, including my own son, who had major surgery as a toddler, will never interact with a child life specialist. In fact, there are only a few thousand currently practicing nationwide, and some hospitals who do have child life departments underutilize them or have even shut them down, including one reputable hospital in the Southern California region.
Why is this? According to my colleague, Certified Child Life Specialist Katie Taylor, this shortage of available child life specialists can be attributed to a few key issues, including lack of knowledge about the profession in the general population, challenges in acquiring the necessary clinical training, low pay and high levels of burnout, and a serious lack of funding.
Despite the significant impact that these professionals can have on young patients, their work just isn’t being prioritized.
Using child life principles in our everyday parenting
As a mom of two young kids, learning just some basic child life principles has transformed the way I approach medical experiences with my kids, from how we talk about it, how we plan for it, how we cope during the experience, and how we process it afterward. And I’m not going to lie, it has had a positive impact on how I approach everyday parenting outside of healthcare settings.
There is no reason that child life and other services, like mental health therapy, should not be available to kids and families everywhere. There is no reason for parents and caretakers to not have access to resources that will help them support their kids through challenging physical or mental health experiences. There is no reason to raise yet another generation of kids with lifelong memories of medical trauma.
We have all the tools we need to improve the standard of care for our youngest patients, empowering them to approach their lifelong health journey confidently and proactively—starting right in their very own homes. So why aren’t we doing it?
Because we believe that we can’t afford to wait, and that all kids should have access to resources that will improve their healthcare experiences, a group of moms, dads, and childrens’ health professionals have come together to make these resources and principles more accessible to families everywhere. We created Piper + Enza, a company focused on empowering parents and caregivers to have all the tools they need to support their kids’ healthcare journey, and are working fervently to get our kids’ books and resources in the hands of as many families as possible.
Going back to the flu shot and my 4-year-old, in spite of all our talking and preparation, he decided he wasn’t having it that day (because he’s 4).
So I took a pause, scooped him up, put him in a supportive comfort hold—a trusted child life strategy—and within seconds, the shot was done, and he was choosing a sticker. He skipped out of the clinic, ready to tell his sister all about it and get the ice cream cone he was promised.
Does your child have a fear of needles?
Here are four child-life approved strategies to utilize during a vaccination or injection to help your kiddo feel more comfortable.
1. Prepare in advance
Depending on your child’s age, you can talk to them about the procedure anywhere from an hour or two to a couple of days beforehand (for toddlers and preschoolers, talking to them closer to the experience is better). Walk through the sequence of events, focusing on what the patient will hear, see, feel, smell and taste. Ask them what part they want to focus on, and which they want to be distracted for. Allow them to ask questions, and validate their concerns. This will help you create a coping plan together.
2. Comfort hold
Never hold your child down during a procedure. Instead, try a comfort hold. In a comfort hold, your child is always upright, helping them feel more safe, secure, and in control of what is happening. Depending on your child’s age, preference and the type of procedure, there are different comfort hold positions you can employ.
3. Give your child choices
A needle poke is often non-negotiable, and something your child doesn’t have a choice about. Giving them choices will make them feel empowered during the experience. Ask them if they want to sit by themselves, or in your lap. Allow them to bring a favorite bandage from home, as well as a favorite blanket or lovey. If possible, give them the choice of which arm to get the shot in.
Taraneh Arhamsadr is a mom, writer, communications consultant, and Piper + Enza’s co-founder. She also writes about motherhood in her blog, the Mamajoon Chronicles.