3 year old is terrified of giving blood

[loveisagirlnameddaisy]

My DD is being investigated for 'tall stature' - she is 116cm at 3.8 yrs (average height of a 6 year old). A necessary part of the investigations are blood tests. Her first lot ever were 4 months ago and she freaked out. Screaming, had to be held down, total nightmare. We even had a play therapist in the room who was supposed to keep her calm enough to allow them to take the blood but she wasn't very effective.

We're due for another blood test next week and DD has asked me each time we go to the hospital if she will have to have 'pins' in her arm again and makes me promise that we won't. How do I explain to her next week when we go to the hospital that this is what's happening?

I assume she has the cream to anaethetise the area?

The best method I was shown for ds at about the same time was he sat on my lap facing me, and I suddled him tightly with his hands behind me, helpd by my elbows. They then did it without him seeing, and being cuddled tightly by me.
Still not a nice procedure, but better than holding him down on the bed which was the option. He was comforted much quicker as well, as soon as they let go his hand he wrenched it back between me and him and was almost straight away calmed.

A sweet in the mouth also helps, I mean to say.

Perhaps, could you persuade her something (a fairy?) needs her blood and will bring her a present afterwards in some way. The nurses/doctors are usually cooperative of such things if you need to coopt them.

Yes, we have the cream DeWe. Last time they used the spray just before, not sure it was as effective. And I held her on my knee last time in that position but she started screaming and wrenching her hands away as soon as she saw the needles (the nurse wasn't 't very discreet when she brought the tray out with the needles and swabs in it). She's pretty strong so I struggle to hold her.

Not sure she'd care less about a fairy needing her blood - she's already decided that it's a bad thing. I'm wondering if I could ask them to take my blood as well which may make her curious and override her fear (she's very curious!).

ask play therapist for some photos + pictures of children having blood tests. have her do prented blood test on a doll. is she aware of being tall? can you explain that the blood tests will help to decide if she needs special medicine to stop her growing so fast?

She is aware of being tall but her fear of the needle would probably negate any reasoning I could offer her about why she needs the tests.

TBH, I thought that's what the play therapist would do last time - use the situation and turn it on its head. Instead she just tried to distract DD by pushing books in her face which actually aggravated things rather than calmed them down.

Get a play doctors kit and practise taking blood on teddy and then on yourselves. We actually got a real blood taking set from the hospital to play with ( sounds dangerous but really not if supervised ). Sometimes kids need to actually touch needles or see them up close to find out that it is not as bad as they think. Put some pins or needle out on the table and let her touch them, sort them into sizes, make shapes with them.
Some kids are actually more afraid of being restrained than they are of the procedure which is also a possibliity after her last experience. I have a tourniquet at home and also practised with that so the nurse didn't have to squeeze dds arm so much ( she hated that)
You can buy Emla cream in a pharmacy and put that on yourself if you are fairy sure of the appointment time - again means less faffing about with strangers.
Get some really good bubbles - they are good for distraction but more importantly getting your dd to blow them slows down the breathing and has a calming effect. If necessary blow bubbles in the waiting room beforehand and hopefully the nurses will play along with you when you get Dd to 'show what great bubbles your can blow ' when you go into the treatment room
If blood taking is going to be a regular thing try to find out of the play therapists run clinics outside your normal appointment times where they can tackle the issues without the procedure actually having t be done there and then.

I remember when my ds had to have blood tests. It used to take 4 of us to hold him down. My heart goes out to you. In the end I would say that yes he was having blood taken as we needed to know about his blood. And then hold him tight with the help of others while the nurse got things done. It is one of the hardest things I have ever done. It just got things over and done with as quickly as possible. Immediately they finished taking blood he would be fine and there were no problems.

I then would come home, and once he was in bed I would weep like a baby and have a glass of wine.

Some for you

My daughter is the same height at the same age. After serious needle trauma after a bout of scarlet fever, they have decided to forgo the testing and wait until she is 7 to see if she evens out. That said, I'm the shortest woman in my family at 5'7"' the tallest female being 6'4", so it's not unrealistic for her to be so tall.

We tried a video on iPad held over my shoulder to distract her and a promised of a trip for ice cream. She still freaked and punched the poor nurse though...

I would try some play "taking blood" games. If you can get a tourniquet let her put it on you and prod your arm then pretend to take blood (if you can get a toy medical kit that would be good). Then try the "your turn" thing, and pretend to do hers.

Effective distraction generally works a treat, an bubbles are a favourite where I work. We sit the children on a parents knee but facing one side (bum on one leg, and their legs draped over the other), and the arm to be used tucked under parents armpit. We never let the kids see anything, and most of them don't know what's going on. Some get upset about having their arm held still though.

Our 9yo nephew, who is autistic, would freak out badly when he needed bloods done, until the time he asked the dr if they were doing a test to see if he's a vampire (bit obsessed!). The dr was great and said yes, but it would only work if he was completely still, and he was.

Thanks everyone for your thoughts. All good ideas. Just got to get it over with now!

RNJ3007 good to know someone else out there is as tall, we don't know anyone else with a child remotely as tall. We've been told what the options are but they'll all wait until she is older and nearing puberty.

Just a small note please don't promise her she won't have the blood tests as it will make the situation worse as you have lied to her.

DD2 has blood tests every year (coincidentally she had them today- she's a nightmare to get blood from and it took 3 attempts!) . I do tell her she is having them as it is something that has to be done. however she sits on my knee and cuddles me we had a lolly ready (but to be fair she wasn't in the mood for it). She did cry a little (it used to be worse but it has got easier I am very no nonsense and don't feed the drama I just hold and cuddle (probably in equal measure ).

(DD2 is 5 but has had them since she was a baby)

I am 27 and just as terrified!! Was a massive shock to me all the blood tests I had to have whilst pregnant. I wish id have known about the cream and bubbles :-) xx

It does hurt if the person doing it isn't very good (eg a nurse). Once I had a proper blood person do it (a phlebotomist?) and I honestly did not feel a thing. They were amazing!! So can you see one of them? Our GP surgery had one on site.

i wouldnt take her tbh.

Quick tip - make sure she has plenty of fluids in her beforehand as if she is dehydrated, the veins won't be as as accessible making it much harder!

I was in your shoes OP. I explained exactly what was going to happen, that mummy will be there, why we need the blood etc. she didn't look convinced, but I made a point in showing her the pretty coloured caps on the blood bottles and I insisted on a blue venflon (small gauge). Phlebotomists don't like EMLA cream, but I looked to see where the best veins are and chose with my DD the 'fattest' one. Then I applied EMLA anyway.
When I took the dressing off, before the nurse cleaned the area, I played a little game: can you feel me pinch here? Yes. Can you feel my pinching where the cream is? No. You try it. Can the nurse play this game? So I just held her hand behind me, let the nurse get on with it.
Because of the gauge of the venflon, it took a bit, so I had in my handbag a couple of moshi monsters blister packs that another HCA opened for us.
I definitely wouldn't recomment a sweetie in the mouth, they could choke.
If the child sees you calm and non plussed, they are calm as well.
Do 't lie, tell the truth, yes, you will have a needle in your skin, just to push the little straw through. I made a point of telling her when the needle was out and reassured her it's only a little straw that's left in there for the blood to come out, I was quite matter of fact, this is how it works, end of.
It worked for me and I think I nailed it, because last time she sat herself in the chair, showed the nurse which vein and sat there happily dangling her feet and watching the blood come out.
Her dad on the other hand, is a nightmare, so perhaps this is also a reason why I was adamant she'll be in control.

Dilidali, thanks good tip about showing her it doesn't hurt once the cream is one. Do you know why phlebotomists don't like the cream?

Doris I only promised the last time we went because we'd been told there were no more blood tests on the horizon, only measurements and monitoring. However, the specialist wanted to take blood there and then last week but I said no, because of the conversation we'd had earlier about the needles. Of course, I'm not going to lie to her unless it's completely unavoidable.

Branleuse If we don't have the blood, we can't rule out a growth hormone problem. I'm not thrilled at the prospect of her screaming the clinic down like she did before, but I'd rather deal with that than her have a lifetime of being unusually tall.

It tends to irritate the skin slightly, making it a bit red and raised/bumpy, making it hard to see the vein. It depends on the skin/how long the cream has been on etc, hence the remark: we don't really like EMLA.

On the height issue, my DD was 112cm at the same age as yours, so not far behind and continued to grow off the scale until she finally returned to the 99.6th centile at the age of 6. She is now 7.4 and has almost dropped to the 98th centile at 135cm. We also had blood tests to check for any growth issues, but nothing found. We frequently tell her how fantastic it is to be tall, and I have no doubt that she will be at least 5ft 10 (I'm 5ft 8), but it is a bit of a relief to see that her growth is finally tailing off just a little.

Thanks TattyCatty, it's reassuring to hear stories of similarly tall children. I am also reassured by the majority of the tests coming back normal although the growth hormone one is high so we still need to get this checked (hence the blood test). But fingers crossed it will be ok and we can just wait for her growing to slow down!

OP - I really feel for you. My dd is older at 7 but absolutely terrified of needles, to the point that she gets extremely stressed at a normal hospital appointment just in case they take blood even though they never do, it's a special clinic for the children. My dd has to be held down, she is huge too and puts up such a fight, it has taken 3 of us to hold her still on my lap with one arm round my back. I really wish they would be a bit more discreet with the needles, last time we went as we walked into the room the nurse was getting everything ready and she freaked out. The Emla cream does help but make sure you apply it correctly, I didn't know to cover it with cling film or a special dressing so it didn't work the first time but subsequently it has helped, and also my dd is a complete wimp so taking the dressing off becomes an issue. We have upcoming bloods in the holidays and I am dreading it already. Am fed up of people telling me not to tell her until an hour before, if I do that ok she won't have as long to panic but will loose all trust in me and the doctors completely, I got away with that once saying it was a cancellation but my dd is quite cycical and not overly trusting so I don't think I could get away with it again!
Good luck!