Recommendations for Keeping 4 Year Old Son Calm During Blood Draw

Updated on October 08, 2009
W.P. asks from New York, NY
15 answers

Last week my son had his 4 yo check up that included a finger prick and 3 shots. He was hysterical during the shots and spent the next two days complaining of pain in his arms and repetitively telling us that he never wants shots again. We (the pediatrician, myself and my husband) have told him that he needs no more shots until he is 9.

It turns out that his lead levels were high and now has to return to the doctor's office this week for a regular blood draw in the arm to retest his lead levels. Needless to say this news is not going to go over well with my son. I feel absolutely awful that he has to go through this, especially since we told him that he didn't need to get anymore shots. My son is very difficult to calm down in a normal type situation that makes him upset and would prefer to kick and scream than me held or soothed. I am thinking about not telling him until I pick him up from school b/c I don't want him to be anxious all day. Looking for recommendations about how to tell him and suggestions for keeping him calm. I am also trying to think of a word/term that may not sound so scary.

Thanks for your suggestions.

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P.M.

answers from New York on

I normally tell my son about a shot as we are driving to the dr office. He is almost 4, and I don't want him to be anxious about it, or even think it's a big deal. I tell him it's like a little pinch, and it's quick. Then I bribe him :). I usually say if he is good about it and acts like a big boy, then we can go and get ice cream or stickers or whatever he is into for the week. I remind him of the bribe as soon as the dr comes in the room so he remembers it. This method has worked for us so far, he asks questions about the pinsh feeling but since I tell him so late in the game that there isn't really a whole lot of time to think about it. He clearly doesn't like it, and he is not an easy person about things he doesn't like. Usually by the time we go to get the reward, he's already forgotten about the pain. We've never drawn blood though. Good luck

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A.D.

answers from New York on

Was one of the shots he had at the last visit tetanus? That can make your arm hurt for days, drawing blood will not. I would NOT tell him ahead of time that he is going to the dr because you are right that he would be anxious all day. Tell him where you are going when you pick him up or while you are on the way to the drs. Tell him as little as possible - maybe he won't be freaked out that day. BUT, don't lie to him if he asks questions.

You need to ignore the guilty conscience for telling him there will be no more shots until he is 9, and be as calm, relaxed and normal as possible.

Again, less is more, but here are a bunch of things you can say if he is asking questions or worried about it.

Tell him no he won't be getting a shot, but the Dr will be drawing some blood from his arm with a needle. This is a "special test" you and the dr didn't know about - see, you didn't lie to him :)

Tell him the shots hurt MORE than the test because the dr is pushing something under the skin with the needle and it stretches the skin and makes the arm hurt. The test hurts less because the dr takes a teeny amount of blood out of the arm, so tiny that it would take 250 of those to fill a drinking glass. Then see if he can count up to 250.

I would explain to him that you know the last shots hurt (3 at once is a little much!) and that this test will not hurt like the last time (even though it will hurt a little). Tell him for some people the test doesn't hurt at all! Again, if the last one included a tetanus shot, i would emphasize that even grownups don't like that shot, but that this will not hurt like that.

If he can be a big brave boy and keep his arm nice and still it will hurt a lot less. Since this is a "special test", if he's brave he can get a "special treat" - just keep it small, in case the results of this will require more tests in the future.

Also, make sure he drinks a lot that day, the more hydrated he is the easier it will be. I would have him drink in the car on the way to the dr's office as well as throughout the day.

Good luck!

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K.P.

answers from New York on

I would tell him on the way- he's little so he probably doesn't have a developed sense of time. He will be worried and upset from the moment you tell him until the moment it is over.

Do yourself a favor and don't lie to him (i.e. "It won't hurt"). I would ask the nurse or technician to make sure that his arm is secured before inserting the needle and would also recommend a barrier (if they have one).

Try not to give him too much info. Just tell him that the doctor needs to do some more tests and that it will probably be unccomfortable and "pinchy". Bring along a favorite stuffed animal to squeeze and maybe a favorite book to look at and distract him.

Be prepared, however, for the nurses to restrain him. It is terrifying to watch, but it is for your child's safety. If he asks you about more shots, don't commit to something that isn't certain. I would just promise him that you will tell him ahead of time. If they need to monitor his lead levels then he will be prepared and you won't look like a fibber!

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T.W.

answers from New York on

If I were you I wouldn't tell him until the absolute last minute. I would just pick him up and take him to the doctor's and tell him he has another appointment if he asks. Then when they come in to do the blood draw you tell him together, but make sure the tech doing it knows what she is doing. Also don't let your son see you are anxious because he will be too. After all is said and done take him out for ice cream or something fun and tell him how proud of him you are for doing so well.
T.

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W.T.

answers from New York on

Hi -- Parents magazine had an article about preventing pain for kids during injections. You might go to their website or your library to look up the article -- it was in a Parents magazine from this summer, and I think the cover even advertised it. There are numbing creams for where the needle will go and general advice for helping through procedures. You might even read the article with your son and let him pick some strategies with you.

Good luck. You might let me know how it turns out, as I've not gotten around to my 4-year old son's blood draw (we have to go to Labcorp to do it, and they couldn't care less about the people they're jabbing...)

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C.C.

answers from Grand Rapids on

it's hard, isn't it!?!? my daughter sounds like she's kind of like your son. i can't tell her things like that too far in advance or she'll be anxious about it until it happens. my son, on the other hand, he's better off if i just tell him straight up what's going to happen. he hates when we just surprise him with something. both of my kids have had to have blood draws. for my daughter (she's 4) we told her about it before we left to head to the lab. we knew she was going to freak out and we'd have to hold her down. we did explain that if she relaxed, it would hurt less, and that yes, it would hurt, but just like a little pinch and only for a second. since then she has had shots, and has done better with them when we remind her that it will feel like a pinch and it will only last a second. for my son (3yo), we tell him way in advance, tell him what's going to happen, and he does great. he had a blood draw this last spring and he didn't even flinch! i couldn't believe it. it just depends on the kid on how it should be approached. i actually think blood draws hurt less than shots, so maybe you could tell him that. either way, i think the truth is the best policy in this case. i think if you don't tell him anything or don't explain everything that's going to happen, it's worse off and then they're mad at you, too! also, i truly think they play off of your emotions, so the more relaxed and calm you are, the better. best wishes!

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L.B.

answers from New York on

There is a numbing cream (that the doctor can prescribe) that you can apply one hour before the blood draw that will make them not feel the stick. We used it with my son (although he was around 7 at the time) and he didn't feel a thing when they put the needle in. He asked when it was going to be over and it was already done. I don't remember the name, but I imagine your doctor would know. Good luck!

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N.D.

answers from New York on

I dont understand why his blood has to be drawn from his arm every week. I think thats excessive and would question the dr. about it. Lead levels will not go away over night or in a week. Next you MUST try to find out how he is getting lead in his system, but I'm sure you know that.
Do NOT tell him until he is in the exam room and about to get the blood drawn. Here is a trick I have used successfully with my babies and it might work with him. Hold his hand palm up and just as he is about to be stuck scratch his palm with your fingernail hard. Not hard enough to break the skin, but hard enough so it bothers him. He will focus on his hand and try to pull it away, keep holding it and hopefully he will be distracted long enough for them to draw blood. At least it will distract him while the needle goes in. I have had a great number of babies get shots (I was foster mom to 97 kids) and none of them ever cried using this method.
Your real problem will happen when he has to go back to the dr and he WILL remember. Then you have to have a sit down talk with him about how sick he will get etc if the dr doesnt test his blood. Tell him you EXPECT him to be a big boy and behave or you will leave the room. Then if he acts up, leave. If he behaves relatively good take him for a treat afterwards. Small toy, ice cream, rent a DVD, but make it special.

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R.O.

answers from New York on

You have gotten responses about dealing with the bloodwork, but have you checked into why his lead levels are high? Check all his toys and anything else he is exposed to in your house. You can check toy manufacturer websites & recall websites regarding lead content in the toys. There are also people that can come into your house with electronic devices that can detect lead levels in anything just by touching the device to the item.
High lead levels can also have an effect on moods & personality traits.
I hope everything works out for you.

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A.H.

answers from New York on

my son would freak with shots too.. the only time he wouldn't was when the nurse sat with him... and i actually walked out of the room.. he was much better for them.. he acted terrible when i was there and we actually had to restrain him.. it was terrible.. so I learned to walk out of the room. I would ask the dr. why does he need the bloodwork every week... have you looked for why his lead is so high.. is it a toy he plays with.. or lead paint in the house.. I would think you need to find the source.. then have his blood checked each month.. find out.. and look for the source.. a lot of toys made in china or even here have been recalled because of lead... go to a lead website.. and check it out.. good luck also when he gets a needle for blood ask for a butterfly needle.. its alot easier on a child even easier than the finger prick.. which actually hurts more because of the nerves in your finger tips..

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M.T.

answers from New York on

Hi W.,
Don't make up words or terms, be honest and to the point, "They are going to draw blood by pricking your finger quickly with a small needle called a lance." I wouldn't tell him ahead of time to "prepare" him. It won't make his pain any less at the time it happens, just make him anxious about it and more time for a tantrum to build. If he isn't open to soothing, will the techs take him in without you? Do you think the kicking and screaming is genuine pain response or is he exaggerating to put on a show for mom? I don't mean to belittle his pain, but it's quite possible that if you are not there to witness it, he may not put on quite so much of a show.
Good luck, I hope it is not too rough on him ... or on you!

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A.S.

answers from New York on

W.,

It sounds like you have gotten some good suggestions re: when to tell your son, figuring out how he developed high levels of lead, etc. I just wanted to offer a few suggestions for during the blood draw. Would it help if you brought earphones for him to listen to his favorite music? Or even a small laptop with a dvd for him to watch? Obviously the blood draw won't take as long as the movie or even one whole song, but it might give him something to focus on instead of the blood draw (I know I need them to talk to me to keep my anxiety down). If there's a favorite toy, stuffed animal, etc., that he has, maybe bring it with you... or if there's time, suggest going to the toy store ahead of time to get something for him to hold as a security object, and/or make a plan to go out and do something special afterwards. If there's something he's been wanting desperately, maybe buy it and tell him that you will give it to him afterwards as a special treat, since this was unexpected and scary and difficult and you know he will be very brave for it.

Also, I would call/check ahead of time who will be doing the blood draw and make sure that it is someone who does blood draws all the time, and especially with kids. If this is more than a finger prick, you want someone experienced with such small veins that they will get it the first time, it will be quick and as painless and possible, and won't leave a bruise. And like others said, be honest and don't tell him that it won't hurt. Try to validate his feelings -- let him know you understand that he is scared and angry and upset (but he can feel all those things without kicking and screaming at the doctor's office). I wouldn't wait until the last possible minute to tell him, because all of his emotions will be running high if he finds out right before you get there. Give him a little time to react and then hopefully calm down and consider the suggestions you have for music, movie, toy, etc. Good luck! (and let us know what happens)

A.

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P.K.

answers from New York on

First thing, I would not tell him until right before going. I would also not go. Have your husband take him.
Chances are he would be better with Dad. Good luck.

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J.C.

answers from New York on

I wouldn't tell him until the day of the draw...if you think he will just worry. If you were able to talk with him about the test ahead of time so he can digest what is going to happen ...he may worry but at least he is prepared. My 7 year old need to have blood drawn for a test this summer and he was anxious..so I explained what they would do...showing him where they would get the blood from a vien in his arm...he dislikes the finger draw and thought that was very painful...once we discussed how the procedure was done..he felt a bit better. I also gave him a challenge..and a funny story that his Dad can't give blood because once he sees a needle he faints...he found this very funny and it became a challenge for him to be brave and not to worry about it. He did just fine and the technician did an excellent quick job. Good Luck...

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J.P.

answers from Albany on

I agree that truth is the best. My daughters have always be nervous but if we explained what would happen when we went somewhere, including the doctor, they were prepared and could cope. If we surprised them with anything - dark, noise, shot they would freak out. Truth builds trust and helps them prepare. For the shots, knowing they get a lollipop the second it is done helps too (I make sure to have them with me since offices don't give them out anymore).

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