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ParentsNovember 30, 2016

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

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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.

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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.

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.

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