"No Doctor, No Doctor": When Your Child is Afraid of the Primary Care Clinician (adapted from Healthy Steps)

It is very common for toddlers to be upset and afraid of "going to the doctor's." Some children are mildly anxious and manage to get through a visit without falling apart. Others are truly terrified and with good reason. They have probably had uncomfortable and painful things happen at other visits, and now they are old enough to remember. No wonder your child cries in protest! How can you and your primary care clinician help your child to feel OK?

• DON'T tease or make fun of your child. Your child will feel bad for having a normal fear response and things might get worse.
• DO talk about the visit ahead of time. Ask your child what she expects will happen. Your child may have fears that won't come true. Let your child know what to expect without focusing too much on any painful procedures. The more your child knows about going to a medical visit the more prepared she will be. If your child is very anxious tell him or her about the appointment only a few hours or even minutes ahead.
• DON'T lie. If your child is going to get a shot, don't tell her she won't. Trust is very important in your relationship. Don't compromise it.
• DO buy a toy medical kit and help your child master her fears. Your child can "practice" and puzzle things out before you go to the visit. Bring the kit to the visit and have your primary care clinician and your child take turns being the "doctor."
• DO come to the office on days you don't have an appointment to play in the waiting room, get a treat, greet the doctor and leave without a visit. This cuts down fears later. Plan this out with the doctor and office staff.
• DON'T let your fear or anxiety about medical visits get in the way. Be upbeat and reassuring. Children can sense anxiety. If you can't handle your own feelings, bring along someone the child trusts who can.
• DO bring comfort objects from home. Bring a favorite stuffed animal, a security blanket, or a pacifier.
• DON'T use illness or medical procedures as a threat. ("If you don't behave, you'll get a shot.") That will make things worse.
• DO stay with your child during procedures. Children are usually less fearful when parents are there to comfort them.
• DO make a plan with your pediatric team. Tell your doctor that your child is likely to be scared so he or she can adjust the way they do the visit. If your child does fall apart, decide on a plan of action with the team. Who will comfort? Who will do the procedure? How will the exam get done?

Adapted from Healthy Steps. Edited and Compiled by the Center for Promotion of Child Development Through Primary Care 2011