How to prepare and support kids for the flu shot
Shaking and sweating. This is how many moms feel when taking their child to a doctor’s office, especially when needle procedures are happening. Fear of how they will respond when informed of the visit leads many to choose to omit or lie about critical information the child will see, hear, and feel. If you can relate, you are not alone.
Still, know that there are strategies and coping tools to help both you and your children with this commonly distressing experience. The best practice is to always be honest, but the amount of information you share and when varies depending on the development of your child, how well past related medical experiences went, and their temperament.
The following are some tips to help make the experience less stressful for you as the caregiver. Use these tips with a grain of salt, appreciating the fact that you know your child best and in general, some days they have a harder time finding the right tool to cope through a challenging moment or experience just like us!
Scheduling the flu shot:
Schedule it on a day and time that truly works best for you and your child. Avoid nap times for young children or end of the child’s school day when they are worn out. School age children might benefit best by going on a weekend “flu shot clinic” day versus after a busy school day when they might feel tired, crabby and less able to utilize coping strategies.
If you have multiple children, it might work out best for your family to schedule two different appointments. Pair the child that copes the best with the child who has demonstrated a harder time. Sure, it might seem inconvenient, but this alone could make a huge impact on the stress of the event for the whole family (that includes you)!
When to talk to your child about their upcoming flu shot appointment:
Certified Child Life Specialist, Amy Fregonese, shared ideal suggested time/days ahead to prepare for each age for surgery in this article, which can also apply to other medical procedures like flu shots.
Toddlers (1-3 years old): Tell your child a day or two before. Toddlers are not able to understand concept of time and may begin to worry if told too soon.
Preschoolers (3-5 years old): Tell your child 3-5 days before the scheduled appointment. This time frame allows these curious children enough time to play out and prepare for their experience. Telling them too far ahead of the appointment allows fears and misconceptions to develop.
Elementary school age (6-12 years old): Tell your child a week (possibly even two weeks for some) in advance. This will allow time to process the information, develop and rehearse a coping plan, and ask questions.
Adolescents (12-18 years old): Involve your teenager in all aspects of the appointment, including when they prefer it to be scheduled (i.e. afternoon, after school or a late morning Saturday flu shot clinic). Allow teens to talk freely about their concerns and avoid downplaying them. Be supportive and honest!
Preparing your child for their flu shot:
Caregiver models effective coping during their flu shot. One strategy my family used for the first time this year was having the children accompany us to our flu shot appointment. In the post “How to support kids for flu shots,” I share how we included our children in our flu shot appointment and how their own experiences panned out a couple of days later. Spoiler alert: giving kids as young as 2 and 3 a sense of control and involvement in their coping plan can help them process and cope with this often scary and stressful medical experience.
Alternatively, if scheduling is a challenge for children to observe yours, set up a time to demonstrate what you did and allow for them to practice role rehearsal.
Medical play. It cannot be stressed enough how valuable promoting medical play (i.e. allowing kids the opportunity to literally “play” out medical experiences using real and toy medical items) is in helping children process and cope with experiences involving medical care. It gives them control and it will also tell you a lot about what they might be perceiving is happening and why. This can allow you as the caregiver to clear up misconceptions or re-frame something to help them understand better.
Create a coping plan. With your guidance, your child helps design their personalized coping plan. If they are old enough to remember and verbalize their account of a previous immunization experience, ask them what helped and what didn’t. Help them realize that there are many different strategies to try that they might not have already.
Here is just a short list of coping strategies if you or your child needs some ideas:
· Watch or look away
· Sit on/next to caregiver or sit independently
· Countdown or no countdown
· Squeeze toy or comfort item of choice in opposite hand
· Freedom to yell out a word (their version of a “naughty” word for older school age kids is a personal favorite of mine because for some kids this is shocking and a treat!)
· Think of their favorite place, activity, etc
· Slow breaths or search for “animal breathing for kids” in your search engine
· Play a word game with older kids like categories (e.g. they pick category and maybe you throw out the letter that s/he has to name 3 of in that category. Keep switching letters and/or categories for distraction)
· Use technology for distraction
· And so much more!
Positive attitude. If last experience was difficult, re-frame for them how this experience could be different. If they are school-age, ask them “how do you wish a flu shot would feel?” They can try to imagine those more positive feelings. Of course, you may need to remind them that they have a choice of how they will cope to help them. They do not have the option to skip it as it helps keep their community in better health.
Give child a “job” and reminders of what else she can do. As an example, “Your job is to try to keep your arm/leg still as a statue, but you can still hug your bear with this arm, squeeze this squish ball, etc.”
Day of their flu shot:
Bring a comfort item, a couple of medical toys, and a distraction item. Since it is a very quick procedure, many items aren’t necessary, just the ones the child will have time to use! Encourage and scaffold them to prep their plush for what to expect, talk to their plush directly “Mickey, you can hold my hand while the nurse gives you the shot in your arm. Maybe you might want to tell “hot dog!”
Share plan of the day. Young children often cope best from learning sequence of events (before they understand concept of time) in order to understand and feel prepared for what to expect each day.
Review coping plan. Even asking 1-3 sentences about how they plan to cope will remind them they have control in how they approach the situation for what’s best for them. Here are a few I asked my 3-year-old.
Some more anxious kids might benefit from less information. This is not the same as lying. Lying leads to distrust and greater outburst for this visit and future ones. If a child who is anxious asks if it will hurt, you can say “everyone feels things differently, you will have to tell me how it feels for you. Dad played a game on his phone and didn’t feel it. I thought it felt like a poke, but then it was all done quickly.”
Simple language for younger children is best. Avoid asking questions that they really don’t have control over and might lead you down a difficult path (eg: Are you ready to get your flu shot?) Instead, use direct communication like “it’s time to get your flu shot. Do you want to listen to x or x in the car?” This gives the child some control while also distracting them.
Sometimes flu shot appointments don’t go as well as anyone hopes. When the child is ready to share, ask them how it went. Try to avoid assuming the child thought or felt it went terrible and hold back from sharing your viewpoint first. Crying is a form of coping and very often parents interpret tears to mean the experience went poorly and that the child didn’t cope well at all.
Bribing a child with a tangible prize to comply in the end is less helpful for them to be empowered to find strategies to help them face challenging situations. If needed, try giving them control in choosing what activity to do afterwards (e.g. visit the park, stop by grandparents’ house, etc). Remember to find grace in this often challenging experience. Grace for yourself and for your child.