If you have been following my series on childhood injections you will be aware of my aversion to holding kids down when they are getting a medical procedure. The alternative is really simple! Holding for comfort rather than restraint.
Comfort holds are more gentle on both you are your child! When held in this way, your child has the opportunity to cuddle you and feel deeply supported by you. The payoff for you is that you aren’t left feeling like you are the worst parent on the planet!
Here are 5 considerations for choosing the right comfort hold.
- Don’t place the child on their back unless they ask to lie down!
When a person is lying down on their back, they are extremely vulnerable. When you child is set up in a position of vulnerability, they are more likely going to fight or flee. It is only natural for a person to attempt for more power. So please, don’t lie them down and don’t suggest they lie down.
It is better if the child is allowed to sit on the parent’s lap. Your child can face outward (their back to your chest) without being about to throw him/herself back. Alternatively, your child can face chest to chest with you while you give them a gentle bear hug.
- Don’t wrap the child up!
Again, by wrapping your child, your child is placed in a vulnerable position – the precursor to fighting or fleeing. When this happens, you become stressed/flustered and the healthcare professionals begin to demand tighter restraint. It’s bad for everybody!
There are some exceptions, however, if your child is under 12 months old is comforted by being wrapped (e.g. you put them to bed wrapped) then wrapping them is probably OK. The key is to cuddle them while they are wrapped and not to leave them on the bed lying down.
- Ask the child whom they would like to cuddle while they have their needle
I like giving children choice as much as possible when it comes to painful, scary procedures. It helps them feel more in control and builds their confidence in being able to face the pain. If there is more than one loving adult with the child the child always gets to choose who will hold them.
It’s also really important that you are calm. “Be aware of your facial expressions… and the intensity of the emotion you express… They’re little sponges and they pick up on everything.” If you are anxious about the procedure, your child will surely be anxious too.
- Give them the option to watch the needle.
I have seen parents forcibly turn their child’s head so that they cannot watch the needle. But this is very similar to wrapping them – you are forcing them into a position they don’t want to be in. I have never seen a child who wants to watch but is forced not to remain calm. Most often the opposite is true.
By asking them how they might like the procedure to go, you are giving them some control and empowering them. This gives them more self-confidence that they can get through this.
- If the child has no head control, what do you do?
If your child is unable to hold their head, it’s best that they don’t ‘sit’ on your lap. Side cradling them, much like when breastfeeding, is a good alternative. Just make sure that the nurse or doctor has access to their chosen injection site (thigh or upper arm). The side they will access will be the side that sits on top of the child while they are cradled on their side.
As I previously mentioned, if your child is normally comforted by being wrapped then wrapping them is probably OK. You can still cuddle them while they are wrapped so long as their injection site is easily accessible.
For more information on how you can adequately prepare your child, support them, and hold them, check out Brooke’s eBook Supporting A Child Through Injections. Or check out Brooke’s website, The Paed(iatric) Nurse today!
Brooke Batchelor is a paediatric registered nurse who currently works in an Emergency Department in Far North Queensland. She is also a parent coach, qualified primary teacher and student Play Therapist. Brooke sits on the Board of Directors for the Association for the Well-being of Children in Healthcare, Australia.