Afraid of the Doctor?

Help kids overcome a fear of shots and the pediatrician

Harsh lights, cold stethoscopes, tight blood pressure cuffs, gag-inducing tongue depressors, machines that go “ping.” The doctor’s office can make people of all ages feel ill at ease. It’s no wonder, then, that visiting the pediatrician is a fraught experience for many kids. The main reason? The series of vaccinations young children undergo seemingly every time they hop up on an examining table.

Hands down, kids' "number one fear is the fear of needles,” says Hillary Israel, MEd, a senior child life specialist at St. Christopher’s Hospital for Children in Philadelphia. Number two is “the fear of the unknown,” according to Zuhair Sayany, DMD, a pediatric dentist practicing at Dentistry for Special People in Cherry Hill and Turnersville, NJ.

A Shot of Courage
It’s tricky to explain to very young kids why vaccinations are necessary, says Israel. After all, the child doesn’t feel ill, so why would they need a shot of medicine? Reassure them that the purpose of vaccinations is to make sure they stay well. When shots are due, advises Dr. Cronan, emphasize that it will be quick and easy, and that you will be there to hold their hand the whole time.

Other discomforting factors include the need to get undressed in a strange place and a lack of familiarity with a given doctor. For younger children, separation anxiety may play a role; for teens, it could be the lack of control. Whatever the trigger, “The fear is not irrational; it is very real to the child,” says Kate Cronan, MD, medical editor for KidsHealth.org and a pediatrician at the Nemours/duPont Hospital for Children in Wilmington, DE.

How doctors put kids at ease during an exam

Doctors have a variety of strategies to try to make kids feel more comfortable in their offices, starting with bright wall colors, toys in the waiting room and child-friendly décor. Once the appointment begins, many allow young patients to examine their medical equipment in an attempt to demystify the process.

This approach worked for Thuy Tran of Audubon, PA. Her daughter Vi, now a freshman at Temple University, used to be terrified of going to the doctor. After Tran mentioned this fear to her pediatrician, he began each visit by allowing Vi to listen through his stethoscope and asking what it said to her. “Eventually she wasn’t afraid anymore,” reports Tran.

How parents can ease fear of the doctor

First, talk to your child about why it’s important to see a doctor. Tell younger children their pediatrician wants to keep them safe and healthy, says Dr. Cronan. With teens, acknowledge the fear and let them know they have your full support.

• Talk about visit in positive terms. “Most kids incorporate the fears that parents portray,” says Dr. Sayany.
• Be honest. Tell them when they should expect to get a shot or a blood test, but don’t break that trust by saying the procedure’s not going to hurt. Instead, say it’s going to “hurt like a pinch” for just a second.
• Give the doctor a heads-up. Dr. Sayany says it’s helpful to know if a patient is anxious. It’s up to the parent whether or not to share this potentially embarrassing information in front of the child; it may be better to call ahead.
• Stay close by. To combat separation anxiety, most doctors are very willing to conduct as much of the exam as possible on a parent’s lap.
• Provide distraction. Whether in the car, in the waiting room or during the exam, distraction can be an effective tactic. Try music and light conversation.
• Allow them to cry. “It’s OK to cry and scream, as long as you hold still,” says Israel.
• Watch Doc McStuffins. Most experts agree that the popular Disney Junior TV show, created by a mom whose asthmatic son was long wary of the doctor, does a good job of explaining medical situations as the title character administers care to her toys. “The show really did did help their understanding of the procedures,” says Dr. Sayany of his own two young children.

How parents can ease fear of the dentist

To prevent anxiety at the dentist, establish a ‘dental home’ by the age of 1, advises Dr. Sayany. The established familiarity makes the dentist’s office a more comfortable place for the child. For a first-time visit, give minimal but positive information about what the appointment will be like. “For the most part, if you tell the child what to expect, they accept it,” says Dr. Sayany.  The "Tell, Show, Do" method works well with children, he says: “We tell them what we’re going to do, show them what we’re going to do, then do it. Then there are no unpleasant surprises.”

Suzanne Koup-Larsen is a contributing writer to MetroKids.