Recently, Pre-Schooler C. needed to go to the GP for a tonsillitis that just would not settle.

“I hate doctors, ” he says.  I statement that, sorry to say, I do take a little personally.  He knows a fair few of us personally and socially and likes us alot. He’s had no bad experiences in healthcare.   Even his hospital trip last year was pleasant enough for him.

On the day, I thought that the appointment was uneventful, quite straight-forward.  C. was happy and calm; the GP was really great with him.

I noticed for the week after that, he was playing doctor.  The boys’ long-suffering “Baby**” was getting the full NCT and a questionable amount of injected drugs. Baby is, on the whole, more cooperative with these sort of games then the family dog.

But is it a game?  Not necessarily.

Playing doctor visit – or hospital visit – can be one way that children process an experience that can be quite scary.  “I hate doctors” can mean: “I’m scared what is going to happen.” or “I don’t like being sick.” or “I am uncomfortable at the doctors” (even things that don’t hurt can be stressful like checking ears and throats.)

**The origin story of Baby is one for another day.

The below post was originally published in 2019, but even a pandemic later, somethings don’t change!

4 y.o. T. has caught a horrible bug from baby brother C. Not sure where Toddler C. got it from, probably licking shopping trolley handle when I wasn’t looking. (Seriously. I just can’t keep anything out of his mouth right now.) C. was thrown down with snotty nose, cough, and temps for 48 hours but was soon back to his usual destructive form. Poor T., though, has been thrown down with cough and temps now end of Day 4.

Expert management at home? Rest (temporary lifting of screen time limits), fluids, paracetamol/ibuprofen syrup, steam vaporizer and Calpol Plug-in at night, Vicks on the chest (not the feet), saline nasal spray…

But T’s still not settling and his ear is now at him — so he’s booked for GP appointment for the morning. (yes, if you are a new follower: Doctors avoid treating their own family and have GPs for themselves/family. It’s best practice).

This led to T. having an epic meltdown about going to the doctor. I find this especially bizarre because 1) he hasn’t been to the GP in a full year. He’s a remarkably healthy boy since he outgrew his infant problems. And last year’s GP visit was very positive. 2)He’s usually positive about doctors: plays doctors, I’m a doctor, his “aunties” (my friends) are doctors, recently announced that he is, indeed, himself a doctor now.

Mammy-me is perplexed. Sensible doctor-me knows that this ear pain is a new experience and scary. He’s sick. He’s miserable. And a year ago is fadó fadó when you are only 4.

But whatever the reason T. is having a meltdown today, it’s not usual. Many (most?) children just hate going to the GP or doctor in a clinic.

So, let’s talk about what parents can do. If you are a mammy of a very young infant, this is easy: we can start now to set you both up for success (or not. Like, seriously, I’ve been doing this with T. since he was in a NICU incubator so you will have bad days anyway.) ! If you have an older child, it will take time to change a negative mindset, but here are some things to think about. [On behalf of my colleagues everywhere, if you find this helpful – share it. We’d all love the most positive interaction possible in clinics and GP surgeries!]

●Studies have found that children’s reactions to doctor were determined by the parent’s behavior/attitude/language more than half the time. So you really have a massive influence on how this whole thing goes!

●Use positive language when discussing going to doctor (and that includes Daddy). Be conscious. No one has to like the doctor, and we certainly aren’t short of business.
Instead of: “I hope that cough doesn’t get any worse or we will have to go to GP – again.”
Try: “If that cough doesn’t settle, don’t worry – we will go visit Dr. X and see if s/he can help make you better.”

●Use affirming and positive and child-centred language.
Instead of “S/he doesn’t like it when she gets her ears looked at.” directed to the GP
Try “Now, time to look in your ears!” directed to the child.

●Give control where appropriate in toddlers with options like “Do you want doctor to look in your Right Ear first or Left Ear first?” Even better if done with silly voice. (Even better if you have an idea which ear might be sore so you can help doctor can start with normal one.)

●Don’t use the word “hurt”, especially saying “this won’t hurt”. If it doesn’t hurt, you’ve just added to fear. And especially if it will hurt, don’t say it. Be honest, so your child will trust you next time. If your child asks “will it hurt?” Say “just for a second. You’re so brave – squeeze my hand.” Even if it is killing you inside, try to smile and distract with a silly face.

●Never lie to your child before or about going to doctor. This will undermine any future attempts to reassure him/her.

●Pop down to your library and pick up a book or two written for children about visiting the doctor or hospital. There are quite a few and they are great! Allow your child to talk through the book and talk through things like “I don’t like it when they look in my ears”

●Role play going to doctor with teddy. “Before we go to doctor, should we check teddy’s ears? Is teddy’s tummy okay? My goodness, isn’t teddy so brave!” (T. regularly plays Teddy doctor, pretending he is me at work. Or our vet. He still is disappointed I only see humans.)

●I am not a big advocate for television or screens, but has your son or daughter met Dr. Ranj on CBeebies? Not a bad place to start! He’s taken on alot of common and scary things for children, from constipation to injections. (Which is exactly what I am doing this evening) Available on YouTube.

●Never use threat of going to doctor as a punishment or a consequence.

●Consider small rewards for “being brave” with doctor. I’m not a big fan of bribery, per se, but positive associations are good. “I know it’s hard to see GP, but if you can be brave today, why don’t we …?” Insert treat here: sticker, visit to a playground, anything small that you reserve for bribery. (Yes, there will be a treat, probably small and chocolate, tomorrow.)

●Always allow child to bring or hold a special teddy or comfort object as well as soother, if age appropriate. Allow child to sit on your lap while waiting and in with the doctor, as much as possible (allowing that, at some point, doc might have to look at tummy, etc.)

●Relax while you are in with GP. If you are still anxious and remembering that last screaming episode, it’s bound to happen again (and, well, still might). One of the most powerful tantrum-bomb diffusers in toddler-parenting arsenal are silly giggles. Don’t be embarassed, your GP will be so thankful to you for any antic that you use to diffuse it. What can you do? Pretend you don’t know where your child’s ears are. If child doesn’t want to show GP belly, be silly and show child your belly. Tickle his knees. Make silly faces your child can see. Try anything silly.

●Vaccines with infants: Hold, cuddle, and ask practice nurse if you can breastfeed during vaccine (will always say yes if you both find position works for her to get to target area.) Bring soother, bottle, comfort object. Try not to let your baby see your anxious face; speak or sing calmly and reassuringly to your baby.

●If it is a non-urgent visit and you know that there is that one GP in the practice who has a good rapport with your child or really seems to get it, ask for that GP when possible.

●Put. Away. Your. Phone. Give your child undivided attention during GP visit…and in waiting room! Their anxiety is going up and up while waiting. And anxious toddler is sometimes just quiet, waiting. Talk, play or distract your child (if you need to use phone: maybe even Dr. Ranj on the phone?)

●Bring your child with you to GP when you attend yourself for routine matters. Stay positive and reassuring during the visit when you get blood pressure check or bloods taken.

●Keep your ear out for events like Teddy Bear Hospitals. They are too rare but are great if you can find one.

Related Posts:

Taking your child to the Emergency Room: https://emdoc.ie/2021/11/23/ochpas-reflect-on-his-ed-visit/

Getting the Most out of your GP or Consultant Appointment: https://emdoc.ie/2022/09/22/your-best-doctor-visit-ever/