Your Child's Check-up

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Lucile Salter Packard Children's Health Services
Parent Information and Referral Center

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Doctor visits are part of every child's life, but they may be uncomfortable and frightening for children, and difficult for their parents. Here are some suggestions to make them easier for both you and your child.

Before the visit

1. When making an appointment, avoid nap time or times when your child may be particularly tired or upset.

2. Feed your child before leaving home; a hungry child is a cranky child. Snacks may be helpful to have during the visit, as long as they don't interfere with the exam.

3. Also bring a stuffed animal, blanket, pacifier, book or favorite toy for play and comfort while waiting and during the exam.

4. Include books about doctor and clinic visits in your child's regular reading. This can be most helpful before a visit, but include them in general reading because visits for sickness or injury are usually unplanned and leave little time for preparation. The best books suggest that visits are not fun, and may be scary and even hurt, but show how kids can successfully handle them. Some books are quite funny. Don't make children listen to a book which they don't want to hear; try another.

5. Buy a toy doctor or nurse kit; let your child use the tools on a doll or stuffed animal -or on you. You can practice with your child such things as opening your mouth wide, breathing through your mouth, and holding still.

6. Bring a camera with you; take pictures of your child during the various steps including reception, the height and weight, and the familiar people. It is often the unfamiliar that is frightening, and you can make a personal scrapbook or picture book to remind your child about past visits. This can be especially helpful for children with health problems and frequent doctor or clinic visits.

7. Bring your child along when you take a pet in for check-ups and talk about how everyone needs a check-up.

8. Always be honest with your child about what to expect. Use simple language and be as specific as possible. The best time to tell children about an appointment varies. Some children need a long time to think about it and get used to the idea, especially if shots are planned; others become more scared if they have too long to think about it. Saying "the doctor will decide whether you need shots (or similar information) after she sees you" is both honest and can help these children deal better with the entire visit. In general the younger the child the less time the better. A six year old may need several days, a two year old may be told that morning.

What can I do?

There are simple courtesies which are important to help things run smoothly. Be on time, and bring any information or insurance papers that are needed.

Remember that you are the spokesperson and advocate for your child. Be aware of any fears, feelings and needs, and convey these to the staff. Be sure that any questions they have are addressed, even if they seem silly or unimportant.

The American Academy of Pediatrics states "the most important 'test' of the pediatrician you have selected is how he cares for your child and responds to your concerns. If you are unhappy with any aspect of the treatment you and your child are receiving, you should talk to the pediatrician directly about the problem." (Shelov, et al. p.8). If your concerns persist, you may wish to consider changing to another pediatrician.

What can make the visit easier for my child?

Your presence is very important to very young children. You are their link to the safe, familiar and comforting. But your mood and state of mind will be very clear to the child, so try to remain calm and reassuring. Sit near, so they can see your face or touch you. Some doctors may allow or encourage you to hold younger children.

Even babies and very young children have a sense of personal space. They can be frightened by any unfamiliar person who comes too close, or touches them. It can be easier for the child if the doctor or nurse approaches slowly, talks to the parents first, and perhaps plays peek-a-boo, or talks about toys with the child, and then gradually comes closer and discusses and begins the exam.

You can also suggest, and practice, with your child some things that will help them cope during the exam. For example, "It's okay to cry when you get a shot, but you need to hold still. I will be there to help you do this."

Other tricks may help. For example, during the ear exam make eye contact with your child and count slowly and steadily to give them something to focus on. They can count along with you if old enough. Other children, particularly older ones, will do better with a brief commentary (from you or the doctor) about what will happen next and what they will sense and feel.

Some children deal best by being distracted; talk about their pets or a favorite game. Older children may appreciate being shown, and even being allowed to hold the stethoscope, the percussion hammer or other tools.

Urge children from four to six years of age to ask their own questions, and speak directly to the doctor. This age is also very sensitive about their privacy. Being allowed to simply pull their underwear down, rather than completely remove it, shows respect for this sensitivity.

Preadolescents and teens should have an opportunity to see the doctor alone so they can share their problems and questions in private, and develop an individual relationship. Children and teens should also be included in health teaching and when procedures or medications are ordered.

Finally, after the visit, hug and reassure your child. There is always something you can praise a child for doing, even if they have been scared and uncooperative, and that is when they need a hug the most! Some parents find a treat such as ice-cream cone or small toy works, but your understanding and support are best.

What is included in the check up?

After checking in, measuring height and weight is usually the first step. It can be hard for a young child to step up onto the small and moving platform. "Handlebars" on the scale can help. Some children become upset in a small exam room with the door closed. If there are no concerns about privacy or hearing scary noises, such as babies crying, you can ask to have the door left open.

You will be asked what changes in your child's health and day-to-day living have occurred since the last visit. You may be offered helpful information about discipline, safety, diet and similar topics.

The doctor or nurse will listen to your child's chest to count the pulse and the respirations. Calling the blood pressure the "arm hug" can make it less scary.

The physical exam will vary somewhat depending on your child's age and the reason for the visit. Basically, the doctor will check to be sure that all the body systems are growing and working properly. Now is the time to ask if you do not understand why something is happening or being done.

At some visits immunizations (baby shots) or eye, hearing and other tests will also be done.

How can I help my child after a scary, difficult or painful visit?

It is usually easier to prevent problems than to make up for them later, but at certain ages, and after certain visits, a child will be upset and frightened. Listen to and reassure your child. Stress that the visit was not punishment, but an attempt to keep them as healthy as possible. Again, using the books and play can help a child work through the experience.

You might try to visit the clinic or doctor's office occasionally just to say hello. This will help your child associate the office with neutral or even pleasant memories.

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Lucile Salter Packard Children's Health Services
Parent Information and Referral Center:
1-650-498-KIDS or 1-800-690-2282