When you choose a doctor for your children look for a child-friendly setting. Ideally there should be a designated area with small chairs or cushions, books, and toys to help them feel comfortable. Often there are wooden beads on rods (an abacus) …a toy enjoyed by almost all age groups.
Prepare your children calmly. Explain what is likely to happen in simple language appropriate to the age. Try not to communicate anxiety to them. Children are very sensitive to stress and pick up your tension very quickly. What you would like to find is a doctor who has photographs of their own children on their desk. …Someone who is at ease with children and talks to them without being patronising.
How you manage a consultation will of course vary with the age of your child.
Let’s look at three age groups: babes in arms, toddlers and school-age children and separately teenagers and young adults.
Taking your baby to the doctor
When you take a baby to the doctor try to ensure that they have a feed first. A hungry baby is not a cooperative baby!
Take a change of nappy as you will need to undress the baby fully for them to be weighed and examined. Undress the baby before you are called in to the nurse or doctor so that you can save time. Take a shawl to keep them warm.
Prepare in your mind the information the doctor is likely to need. For example: How long has the baby had a temperature and how high did it go? Has the baby been off his feeds? Are the stools runny or hard (constipated) ? When did the baby last have his bowels open? Have you noticed a rash?
Have the courage to say what you are worried about and don’t hesitate to go back again if things don’t improve in a reasonable time.
You may be a first-time parent and anxious about your child. Don’t worry that you are being too ‘precious’ and demanding (within reason of course!).
Child medicine is an imprecise science and doctors maybe in the dark just as much as you. However, they would prefer that you let them see the baby and be able to reassure you, rather than allow things to go badly wrong at home with no guidance.
Toddlers and school-age children.
One good way of taking the fear out of a visit to the doctor is to introduce your child to a doctor’s role and to all their special instruments in an entertaining reassuring way by watching a DVD together.
Playing with a doctor’s or nurse’s set of toys also breaks the ice. Help them to care for a ‘sick’ Teddy so that they can see what is likely to be involved.
As they grow up children often develop a special vocabulary to describe what they are feeling. Part of your job as a parent/guardian is to interpret their description for the doctor. Having a ‘sore tummy’ may for example mean that the child is constipated and has some gut spasms associated with that.
Descriptions of feeling unwell need some careful interpretation. A child may copy a grownup word and say they feel ‘poorly’ or ‘off colour’ or ‘sick’ and this may mean anything from a temperature to a headache, nausea, or pain.
In response the language needs to be simple and non-medical. You may need to try more than one way of saying the same thing. Look ahead and anticipate. Tests need to be explained. Most of us live in dread of needles and children feel just the same. It helps for example to tell them that an x-ray is just a photo and there are no needles or pain involved.
When you take your child to the doctor it is you who will do most of the talking but turn to the young one often, check they agree with what you are saying. Ask them to contribute occasionally. Keep your child close to you. Sit them on your knee for reassurance and when the doctor examines them keep a hold on them…. touch an arm or an ankle. All this is calming and reassuring. We all feel sensitive when we are unwell, and children can feel particularly vulnerable. They are not yet wise enough to have any insight into their feelings and can find illness quite overwhelming.
Explain that the doctor is there to help and that you are lucky to have a good doctor to talk to.
Many children see the doctor only when a vaccination is needed.
Best to be honest about vaccinations, but not too graphic. Tell your child that there will be a moment of short discomfort but that it is important in order to keep them well. Tell them that it may be unpleasant but will be over very quickly. Encourage them by offering a reward for being brave…. a small present or a special outing for tea. Always follow through with your promises or your child will lose faith in you.
Be aware that sometimes children seem to be unwell and say they are ill if something else is afoot. Could there be bullying at school? Could they feel unhappy at home for some reason that you are not aware of? Psychological distress is worth considering if a child appears to be seeking attention rather than being genuinely unwell.
As children grow up, they become acutely aware of their bodies and are easily embarrassed. Be careful to protect their privacy from an early age and use the curtains in the doctor’s office to make them feel private and safe. Children often don’t like being unclothed in front of strangers and even in front of a parent if a stranger is present.
Talking to Teenagers and young adults.
As children grow up, they want to demonstrate some independence. They may want you to do the driving and sit in the waiting room but may not want you to come into the doctor’s office. They may want the reassurance of knowing you are there but want to make their own relationship with the doctor. Negotiate beforehand. Perhaps you might like to have a quick word with the doctor and your child together at the end. Suggest the teenager and doctor agree what can be shared and what should not.
As children mature, they grow into their responsibilities and gradually acquire the capacity to make important decisions for themselves. The early teens are an in-between stage. Often there is an inconsistent combination of independent thinking and yet reliance on a parent. Sometimes children are not keen to grow up and want to offload responsibility to their Mum. Youngsters do however need to be encouraged to take responsibility for themselves and their own decisions. They need to understand how to look after themselves and keep themselves safe and healthy. This becomes even more important later when they are faced with decisions about smoking, drugs, and contraception.
There is no age-related cut-off point at which a child grows from dependency to independence but rather a process of maturing understanding and developing self-reliance. Some children who have had serious illnesses develop this maturity early while others with untroubled lives may be relatively late. Contraception is always a thorny issue, but common sense suggests that trusting a girl to decide for herself is much better than an unwanted teenage pregnancy. Hopefully the doctor who is asked for a prescription for contraceptives will explore the motivation and check that the young woman is making a voluntary choice and is not being pressurised or bullied. For your part keep up the communication if you can. Driving together in the car is a good moment for these tricky issues as you do not have to confront each other or stare each other down!