I took inspiration to write this from my daughter’s experience of having her own pre-school injections done today. I feel privileged that with my training as a Clinical Psychologist and particularly my training in CBT, ACT and CFT that I have helpful tools up my sleeve for these situations as a parent.
- Consider your own thoughts and feelings about going to a clinic during lockdown – do you have any worries or concerns? Is there anything you want to clarify with the clinic staff before you attend? When we went, I was reassured to see a sign on the door discouraging anyone with coronavirus symptoms from entering, and also to see all staff were wearing masks and using gloves and hand sanitiser, which I was also offered. It’s helpful if you feel confident it’s safe and know what to expect, as your child will take their lead from you.
2. Does your child know what to expect? You might want to have a chat with them beforehand to prepare them, keeping it light-hearted and practical. I found it helpful that my daughter had several recent experiences of taking her baby brother to the immunisations clinic so was pretty clear what was involved, but without that recent experience we’d have had more of a chat. Positive associations are ideal if you can introduce any. We’d been to climb a hill named after the immunisations clinic building recently, and we had a routine of going to Costa for hot chocolate after my baby son’s injections which were both good positive memories for my daughter to link with what we were doing. She also has an interest in “being a medical doctor” when she’s older which was also useful to talk about in the context of the purpose of injections. Even though she knew the basics, we still covered that she would be getting one injection in each arm and that the purpose was to protect her against illnesses, that it might be a bit scratchy but she would get to choose a treat afterwards. Injections are also a great opportunity for children to learn about how we sometimes need to do things that feel a bit yucky to keep us well and safe, and to learn that facing something unpleasant with courage can boost their confidence and resilience.
3. If you have other children and someone else who can look after them so you can take your child 1:1, that might be helpful. I was glad my husband had been able to look after my son, as that way I could hold my daughter on my lap for a cuddle, which turned out to be pretty important as when she decided she didn’t like the feel of the first jab in her skin, she reached out the second time to grab the needle to stop it going into her arm which might have been a bit dicey if I wasn’t holding onto her at the time.
4. Plan how to cope with anticipatory anxiety in the waiting room – often this is the worst bit. Whether its you or your child who will be the anxious one, it helps to have some ideas. It’s helpful to bear in mind that there won’t be books and toys out, which surprised my daughter as she’d enjoyed playing with them at her brother’s appointments. During a pandemic however, the risks of playing with a shared pool of toys are clear. So instead we played alphabet games, taking turns to come up with a word for each letter of the alphabet. Other ideas might be to bring a toy, book or game with you, or to sing action songs.
5. If your child asks questions, try to answer them honestly but positively if you can- e.g. “Will it hurt?” “It’ll be a bit scratchy but you’ll get a sticker for being brave after”. You want them to trust you, and children are pretty good at lie detecting.
6. If your child gets anxious at the time of the injection, you could try encouraging them to take a deep breath by modelling it yourself. A big cuddle might be the most helpful thing for a pre-schooler. Distraction might also be helpful, we kept our alphabet game going during injections, and our nurse was kind enough to join in which was really appreciated. If your child’s mind is busy thinking about something they find interesting, it’ll be less able to trouble them with scary thoughts about needles.
7. Make sure you give your child a big hug, show empathy for any negative feelings they need to express and praise their bravery after – I also went out of my way to tell everyone else we saw that day how brave my daughter was in front of her, even the lady who sold us the sweets my daughter chose as her reward in the shop after – I am grateful to that kind lady for making a fuss of her. When children hear other people say they are brave enough times, they’ll start to internalise the thought themselves and feel good – and hopefully also more likely to want and expect to “be brave” next time too. When we say brave, it’s helpful to consider that a child who is terrified and cries throughout but still manages to get an injection has been phenomenally brave, just as much as the child who doesn’t express any emotion but perhaps feels it intensely inside.
8. When we came home, we then did some routine mindful garden watering to calm our minds. Mindfulness in the garden is soothing for us, other people might prefer a different mindful activity or even just a cuddle together with a hot chocolate and a book or TV.
9. It’s helpful to be willing to debrief the experience with your child if they want to. They might not, of course. If they do have questions or need to express their feelings though, it’s helpful to listen and give answers that fit their developmental stage – so keeping it simple and practical. For example, my daughter wanted to know when her next injection would be, and seemed a little disappointed it wouldn’t be until High School – a whole other developmental stage, and managing that would be a whole other blog post.
10. Last but not least – if you find the process of taking your child for injections stressful or upsetting yourself, do something kind for yourself afterwards too, when you can. Maybe watch something you enjoy on Netflix, have a cuppa or a bubble bath. You deserve a reward for getting through that too!
Mummy ACT 