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ParentsNovember 30, 2016

How to support a child who needs a blood test, by a parent who knows

Guest writer
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There’s no getting around it – blood tests suck, especially for confused and scared children (and their upset parents). Paediatric blood test veteran Kiki Van Newtown shares some advice for getting through the procedure with the minimum of tears.

The wonderful Kiki Van Newtown is back writing for us again! If you didn’t read her first piece about parenting her daughter then you definitely should go back and read it. Here she writes about blood tests, something she knows a lot about. Taking your child in for any kind of medical procedure is terrible – it’s hard for your child, hard for you, and often hard for the medical professionals helping you. But what must be done, must be done. We are all about helping parents here – I hope this guide helps you. – Emily Writes, Parenting Editor.

I am no medical expert, but I do know that blood tests suck. Especially for little kids. One of my kids has had more blood tests than I can count, most of which have sucked immensely. But over the last four years we have been incredibly blessed to meet the most caring and emotionally generous medical practitioners who have taught us all the tips and tricks they know to make blood tests easier. Doctors who sung lullabies to our tiny baby as they attempt to get a vein. Receptionists who dropped what they were doing to come and be on bubble blowing duty. Nurses who delivered plates of fruit pudding and ice-cream to my wife and me after a particularly excruciating Christmas day test. And all the while these incredible people have taken the time to talk to us, help us and our kid understand the process, and have validated and sympathised with how much blood tests suck for everyone.

So this is some of what I’ve gleaned from them, some of my own thoughts, and some commonsense stuff – like that food treats are legitimate coping strategies. Please note: this is not actual medical advice. Please remember to always take your medical advice from someone who is qualified to give you it, and who bases their advice on peer-reviewed research, as opposed to bloggers/YouTube stars/crank doctors who wanna sell you holy water.

Baby girl crying

General Advice

Doctors and nurses are people too. They don’t like stabbing at babies with sharp needles, but they are dedicated to doing everything they can to help keep our kids healthy. Be kind to them; ask them how their day is going.

Be your child’s advocate. This is so crucial, and yet can seem so impossibly hard. To be a great advocate you need to build open channels of communication with the doctors and nurses you are dealing with. Understand that you’re both on the same side – wanting the best for your child – and that this is going to be shitty for everyone involved. Engage them in a dialogue to develop a plan for the procedure. This doesn’t need to take long, but will clear up any misunderstandings, and ensure that everyone is following the same plan. Explain what your limits are for attempts, and how you will indicate if you need them to stop. You know your kid the best, and you will have the best idea of how much they are able to tolerate.

Understand the test. What are they testing for? How many vials need to be taken? Understanding these things will help you develop a plan for the test. If your child will possibly end up needing an IV afterwards discuss this with the medical team, and ask them to put one in straightaway – one puncture is always better than two, aye! If it’s a simple test, can they get the results from a finger prick? Don’t be afraid to ask questions, and don’t be afraid to insist on alternate plans even if it is not how things are usually done.

Know your kid’s body. If they’ve had tests before, remember what has worked and what hasn’t. Keep a note of any easily accessible veins. Ask for the blood to be taken from the opposite arm that your child favours.

Involve your kid in the process. Talk to them about it. Ask for their input. Give them choices where you can. If your kid finds the blood test particularly upsetting validate their feelings and engage with them to help them process the trauma. Teach them how to be a good advocate for themselves in the future.

Be conscious of body autonomy. Explain the procedure to your kid. Talk about how as their parent it is your job to keep their body healthy. Part of this is that sometimes you need to make decisions about their body on their behalf, and this is one of those times. Set up an ongoing conversation about body autonomy and consent with your child. Kids undergoing medical procedures often feel confused about why in these situations they are restrained and hurt. Starting this conversation at an early age will help your kid understand and practice body autonomy, and learn how to make informed decisions about their own bodies as they get older.

You need support too. Take a support person with you. Warn them what it might be like, and make sure you pick someone who won’t end up crying on the floor before the procedure has even begun. A difficult blood test can leave a parent feeling shattered. Make sure you have someone who can pass you the chocolate and drive you all home if need be, and then feed and play with your kid while you work on compartmentalising the trauma in a totally healthy way.

More Specific Advice

Having kids is a riot that basically consists of trying to make plans within constantly shifting paradigms. Here are some tricks that I’ve learnt, broken up in to general age categories.

For tiny babies:

  • A tiny baby will not understand what you tell them about this procedure. Explain it to them in advance anyway – this is good practice for when they are a bit older.
  • Have you got food ready for after? Something almost instant like a bottle or boobs or a pouch is easiest. This will help soothe the baby as soon as it’s over.
  • Can the sample be from a heel or finger prick? Some kids don’t bleed as well from these points, and it also depends on what they are testing for. Ask first and if possible try this route over a cannula.
  • If it does have to be a veinous sample get the most experienced person there to assess your kid’s veins. Use all the tricks: bending the hand, a torch under their palm in a dark room, drawing on them with ballpoint pen. If they find a good vein remember where it is for future use!
  • Swaddle the bejesus out of that baby. Are they asleep? Leave them asleep – they might not even wake up!
  • Ask for a syringe of glucose syrup, or take your own syringe filled with sugar water. Feed this to your baby right before the test to release pain-relieving endorphins.
  • See if you can hold the baby on your knee – it’s often easier than trying to restrain them on a bed.
  • Hold on tightly.
  • Try not to cry, or cry all over your baby.
  • Go and buy yourself a treat.

For 1 – 2 year olds

  • Explain to your child what is going to happen. Kids this age have a wacky sense of time, so use your judgement how far in advance they need to know to minimise stress.
  • Get your food together. Favourite snacks, drink of milk, coins for an ice-block, boobs, dummy, lollypop.
  • Glucose syrup doesn’t work for older kids. Instead put EMLA cream on the back of your kid’s hands and in the crook of each elbow 40 minutes before the test. You can ask your doctor for some, or arrange to pop in to the clinic prior to the test to get it applied.
  • Check what type of blood test this is gonna be. If it’s a cannula decide how many chances they get to hit a vein. Your child does not need to become a pin cushion because one person can’t find a vein. Talk to the medical staff about this before the procedure so everyone is clear on what will happen, and what the contingency plans are if they can’t get the sample they need.
  • Swaddle your child if possible, otherwise hug them backwards in a chair, with all of their limbs cuddled in to you except the one arm/leg that is needed. This can stick out from under one of your arms.
  • Get someone to distract your kid. Bubbles are great.
  • Expect crying and screaming. Your kid is being forcefully restrained and poked at without their consent. This is alarming and in any other circumstance would be unacceptable. Validate your child’s feelings. Commiserate with them. Reassure them calmly.
  • Scream on the inside.
  • Go and get you and your kid some cake and stickers.
More Reading

    For 2-4 year olds

    • Tell your kid they need a blood test. Explain why, and let them ask any questions. Let them talk directly to medical professionals if they want. If they’re upset acknowledge that blood tests do indeed suck. Discuss how most blood tests happen pretty quickly, and that they are important for keeping our bodies healthy.
    • Ask your kid to choose a favourite toy to take.
    • Snack, snacks, snacks. Treats, treats, treats.
    • Apply EMLA cream. If you aren’t able to do this, ask for a freezing spray like Vapocoolant to be sprayed on the site where blood will be drawn from.
    • Have you got Peppa Pig or some equally as numbing kids’ show up on your phone yet? This might not work as a distraction during the actual procedure, but is good for calming nerves beforehand.
    • Discuss the plan with the medical team. Don’t worry about taking up precious time – better to have everyone on the same page before the blood draw, so you’re not trying to communicate over the sound of ten thousand cyclones of screaming mid-procedure.
    • Give your child choices where you can. Ask if they would prefer to sit on your knee or on the bed. Ask if they would like bubbles or a book. Ask what song they want you to sing.
    • Bubbles. Have you seen those motorised bubble machines that blow hundreds of bubbles at a time? Brilliant.
    • Reassure your child. Talk about what you will do after it’s finished. Keep your voice steady and calm.
    • Have some fancy plasters at the ready. Let your kid put one on their toy.
    • Afterwards wipe your child’s face with a warm flannel. Go get yourselves some cake!

    Kiki Van Newtown is the parent of two kids, who she raises on a diet of hashbrowns, soysages, and feminist discourse in the upper Lower Hutt. In between convincing young children about the merits of wearing pants and bringing home some bread and butter, Kiki performs with her wife GG and best friend Liz in their band HEX (check out their Facebook page here). She blogs semi-regularly for The Spinoff Parents.

    This content is entirely funded by Flick, New Zealand’s fairest power deal. In the past year, their customers saved $417 on average, which would buy enough nappies for months… and months. Please support us by switching to them right now.
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    Keep going!
    Holly Walker’s daughter Esther at home.
    Holly Walker’s daughter Esther at home.

    ParentsNovember 29, 2016

    A whole good day: When parenting finally feels like you thought it would

    Guest writer
    Holly Walker’s daughter Esther at home.
    Holly Walker’s daughter Esther at home.

    Being a parent means a never-ending series of problems, big and small, and often it can feel like a struggle just to make it through the day without collapsing in an exhausted heap. Until one day, it doesn’t. Holly Walker writes about the small joys, and the days that make it all worthwhile.

    On the day my daughter turned three, a man gave me a chopping board. It was a lovely chopping board, made from caramel-coloured blocks of recycled rimu that had been glued together and clamped in a vice. The man had made it himself. He brought it over to my house in the afternoon, along with a miniature Pinky bar for my daughter, Esther.

    I met this man about five years ago, when I was first running for Parliament. He was the chair of the local peace group, and hosted a debate for the candidates. Later he became a dedicated campaign volunteer. He was kind and generous, and donated several of his chopping boards to fundraising auctions. After I left Parliament, earlier than I had planned, he asked if he could gift me one as a token of support and appreciation. It took me almost three years to follow up and accept his offer.

    It wasn’t that I didn’t want it, though we did have three other chopping boards already. Two were wedding presents, building blocks of our joint kitchen. One was a birthday gift from my stepfather about two years ago. That one was made from a slice of fallen pohutukawa tree blown over in the wind on Great Barrier Island. We used to be good at taking care of them, oiling them regularly along with our cast iron pans, but slowly we fell out of the habit. After Esther was born and I left Parliament, things were hard. I was having trouble with anxiety, and my partner was suffering from chronic pain. Maintaining our possessions, and even making a time to receive a gift from a kind supporter, were low on the list of priorities.

    We took the same approach to most of our responsibilities apart from keeping ourselves and Esther clean, fed, and showing up in the places we needed to be. That was enough – often it felt like too much. Our front fence, which is a retaining wall, is sagging and cracking. Each time there’s an earthquake in Wellington, it cracks a little more. In the big one the other day, a cinder block fell clean out.

    There is a 1976 Mini Austin Clubman slowly rusting in a neighbour’s garage across the road. We bought it in the summer after I was elected to Parliament, with visions of me becoming ‘that MP lady with the little green car’. We drove it back from Kaiapoi while I memorised my maiden speech in the passenger seat. We meant to sell it three years ago, but we can’t seem to do it. Every three months we renew the registration, resigned.

    Our house is called the Herb Cottage. The woman who lived there before us was a herbalist who operated a massage studio out the back. It smelled of lavender and calendula when we moved in. We knew she wanted someone to buy it who would take care of her herbs, so we wrote her a letter to that effect to accompany our offer. She accepted. Three years later, the garden runs wild. Fennel taller than us chokes the apple tree, nasturtiums spread across the lawn from every planter bed, and the garden seat her husband built has rotted and collapsed.

    Inside the house, paper and books are piled on every surface. Esther’s odd socks are sprinkled through the house like seasoning. The cat luxuriates in piles of clean, unfolded washing. Sometimes I feel like we exist on the surface of our life. We get through each day, run the dishwasher, eat, and collapse into bed to do it all again. Dealing with longer-term projects seems impossible, overwhelming. So, we don’t. Most of the time I no longer feel guilty about this, recognising that survival is our primary aim. Most of the time I’m okay with that. But it’s hard.

    The other day was a good day. A whole good day, from start to finish. All three of us woke refreshed. Dave cooked us a breakfast of mushrooms on toast. The sun was shining. We took a family outing to the new playground at Avalon Park. Dave slept in the warm sun while Esther and I explored. She was in her element, brave, adventurous, independent. We stayed for two and a half hours. I wish I could live here, she said to me as we left – but she left without complaint. We went to a café for lunch. She was dehydrated and hungry after her morning of playing in the sun, but she lasted. We came home. She didn’t fall asleep on the way. We watched a movie – Inside Out – to get through the post-lunch lull. She didn’t fall asleep then either. I painted her nails. She didn’t really get the movie, but she watched it anyway. “When I’m five I will know how to watch it,” she said. I cried, especially at the bit when Joy realises that she needs Sadness with her. That you can’t have one without the other.

    Then Esther helped me make dinner. She had her own pan and little bits of each thing I was cooking, and she stirred and chatted away. The meal was ready early, and she ate it. Every last bit. Then she had a bath, read a story with Dave, a story with me. I turned out the light, sang her Pokarekare Ana, and she was out.

    It was a day just like I thought every day as a parent would be but which so few of them are. A day in which Dave and I were both present, and relaxed. A day in which Esther had fun, and all her needs were met. In which we rested, ate well, and took care of each other.

    After dinner I drank a glass of wine and oiled the chopping boards, all four of them. They came up just fine.

    This content is entirely funded by Flick, New Zealand’s fairest power deal. In the past year, their customers saved $417 on average, which would buy enough nappies for months… and months. Please support us by switching to them right now.