It is not uncommon for children to worry when they hear they are “going to see the doctor.” Some children openly express their feelings, yet others will keep theirs a secret. As parents, we can help our children overcome their fear or anxiety about visiting the doctor by being in tune with our children’s behavior before, during and after the appointment and responding with compassion and support.
Specific Reasons Why Children Worry
The reasons why children worry can vary by age, personality and health history. Here are few common reasons a child might feel afraid of going to the doctor:
- Separation anxiety - It is not uncommon for older infants, toddlers and preschool age children to fear separation from their parent. Infants as young as 4-5 months can develop separation anxiety, though most will develop robust anxiety by the age of 9 months. This is a typical part of development, and is not considered abnormal unless the anxiety is severe, occurs daily for more than 4 weeks, or persists beyond 6 years of age.
- Pain – School age children often worry about pain associated with visiting the doctor. The most common concern is whether they will need a shot.
- Fear of the unknown – It is not uncommon for doctors and parents to use words or terms that children do not understand, which can cause some children to worry there is something wrong or that they are sicker than they think. Children may also worry about needing surgery or needing to be hospitalized. This may be more pronounced in children who have had an older family member with chronic medical needs requiring frequent interventions or hospitalizations.
- Fear of death – Children begin to understand the concept of death around the age of 4 years, with a full understanding by age 7. Children with chronic medical illnesses, or who have lost a loved one, may worry about death and dying.
- Fear of the doctor – Many things about doctors can be scary for younger children. A doctor who is tall or has a loud voice may seem intimidating. This particularly true when meeting a doctor for the first time, as your child will be examined by a complete stranger.
Regardless of where your child’s fear may originate, or how your child responds to that fear, there are ways you can talk to your child and help them overcome their worries.
Ways to Help Your Child Overcome Fear of the Doctor
Here are some DO’s and DON’Ts when talking to your child about visits to the doctor.
- DO talk with your child openly about the visit. Give them advance notice so the visit is not a surprise. When talking about the visit, be honest and talk about the visit in a positive way.
- DO tell your child why they are going to the doctor. Use language that is appropriate for their age. If your child is ill, let them know the visit will help the doctor figure out why they are sick, and how to help them get better. If you are taking your child for a routine checkup, explain to them the purpose of the visit – to make sure they are healthy, growing and developing the way they should. Let them know the doctor will need to do a full physical exam, and that all children have physicals at least once a year. Even adults have routine checkups! Let your child know they will have a chance to ask the doctor questions about their body and health.
- DO read books about going to the doctor. Role play with younger children before the visit. Purchase a toy doctor’s kit. Practice listening to each other’s hearts or other common practices a child might encounter at a doctor’s visit.
- DO take your child’s favorite toy or stuffed animal for comfort.
- DO validate your child’s fears and provide reassurance. Tell them, “I know it’s scary. It will be over quickly, and I’ll be right here with you.”
- DO provide support for your child, and reassure them that the condition is not their fault, and that many other children have similar problems.
- DON’T use the visit as a form of punishment or blame. Some children feel guilty. They believe their illness is due to something they have done wrong, and may also think vaccines or treatments are a part of their punishment.
- DON’T keep visits a surprise. Most children cope better with stressors or pain if they know in advance, and speaking honestly with your child will help build trust. If you are unsure of what will take place during the visit, be honest with your child about that, as well, but reassure them that you will both have time to ask questions.
- DON’T threaten children with shots or promise they won’t get any. Parents sometimes threaten their children with shots, as a means of controlling behavior, e.g. “If you don’t sit down, the doctor is going to give you a shot.” This can undermine the relationship your child has with their doctor, and is not a long-term solution to manage behavior. What you can do is let them know they will not get shots at every visit.
- DON’T tell your child, “Shots don’t hurt” or “Don’t cry.” This can make you less credible.
- DON’T tease your child about potentially embarrassing conditions such as scabies, lice or bedwetting. They may already be teased or bullied by other children.
Remember, it is not uncommon for children to feel anxious, nervous or scared when it comes time to go to the doctor. Your support and reassurance will help make the visit go as smoothly as possible.
by Dr. Carmela Sosa, Medical Director of Valley Children's Primary Care Group and the Guilds Center for Community Health.