A trip to the doctor’s clinic for many children can be a traumatic experience. Much of the stress and fear in a child can be banished if parents prepare the toddler on why the visit is important and how the doctor can help the child feel better. “There is already a fear of strangers in toddlers between 18 months to five years,” says Dr Shahid Gauhar, neonatologist, Medcare Hospital, Dubai. Also, after the age of one, a toddler experiences fear of separation from parents, he says. In the UK, for instance, paediatricians are told not to wear white coats as it scares children, says Dr Gauhar. “We were advised to wear ties with Mickey Mouse or other cartoon characters to win over a baby’s confidence.” There are many things parents can do to ease their child’s anxiety over a visit to the doctor.First, children need to be told why they are visiting the doctor and what he will do. Giving the child a clear idea of what to expect is less likely to scare him when he is being examined or asked questions. Once in the clinic, there are a few basic precautions parents and doctors can take. For example, to play down the separation anxiety in very young children, they should be allowed to sit in the lap of either parent as the doctor examines the baby. This prevents them from being traumatised, says Dr Sami A. George, paediatric specialist, Canadian Specialist Hospital, Dubai. One of the worst things parents can do is to paint the doctor as a disciplinary figure. “Some parents tell their child they are taking her to the hospital as a punishment,” says Dr George. That makes the child terrified of doctors. In adult life, this fear manifests as the ‘white coat syndrome’, he says. The golden rule, according to both specialists, is honesty. Be truthful to the child. If an injection is going to hurt, say it might hurt a little but that she will feel better afterwards. Vaccinations, for instance, are painful for children. Toddlers have to be vaccinated from time to time and it is painful as it punctures the skin. Parents should not treat this lightly and ensure the child knows what to expect and why it is being done. They should be prepared before they are brought to the clinic, advises Dr George. They should be told what it is for and how it can benefit them. “I see some children screaming while being given vaccinations, while others thrust their arm out and say,’Give me the injection’,” he says. Much depends on how parents prepare the child. He suggests local anaesthesia be administered before vaccination to dull the pain. Dr Gauhar recommends a herbal gel, Amla, be applied to reduce the intensity of pain. But the most important pain reduction factor are parents’ attitudes. Humour or distraction usually works, but excessive reassurance or apologies at this time tends to increase distress, both specialists agree. Doctors too need to adopt a different approach when dealing with kids, says Dr George. Apart from the bright, reassuring decor of a children’s clinic with cartoon figures on walls and playthings strewn around, doctors are expected to bring an informed way with children. Dr George says there is an instruction manual on how doctors should handle children, how they behave and talk to them, much like the bedside manner of physicians. The important thing is to never rush through a case. “You need to talk to the child to win his confidence,” says Dr George. That requires at least 15 to 20 minutes with each child. Both doctors agree that in many hospitals and clinics, doctors are made to handle too many patients a day. “In Canada, we used to see 10 patients a day,” says Dr George. His other advice for parents: Don’t get stressed if the doctor cannot see you immediately. There are parents who expect the doctor to see them immediately. Doctors should respect patients, but patients should also respect doctors’ time,” he says. The anxiety and nervousness of a parent is sensed by the child, so it is important parents stay relaxed and calm.from gulfnews.com