If you have a child that is diagnosed with a thyroid condition, be prepared for blood draws, particularly if they are born with congenital hypothyroidism. In the first few days/weeks, your child’s doctor will probably want repeated blood draws to be sure that the surge in TSH isn’t a newborn surge (sometimes it’s so high it’s clear that it isn’t just a surge) and then once they start medication, they will check to be sure that the medication is working. As infants, my boys were checked every 2-4 weeks for a while. Surviving blood draws becomes crucial to everyone’s sanity.
Here are my best tips:
Blood Draws with Infants
1) RELAX!!! Seriously – take a deep breath and relax. If you are uptight, then your baby will sense this and so will the phlebotomist…and that’s a recipe for disaster or at least a bad blood draw experience. I know what you are thinking – that this is torture for your baby, it hurts and it will scar them for life. I have a 7 year old, who is totally cool with blood draws now, so I can tell you they won’t remember this, especially if you don’t make a big deal out of it.
2) Allow plenty of time. Once you arrive, they will have to place a heel warmer on your baby’s heel, so you’ll need time for that to work. Never go expecting to breeze in and out (and be sure anyone with you understands that and is willing to wait with you).
3) Bring help but leave your other kids home. If you have other kids, try to leave them with another family member, so you can focus on the one getting the blood draw. If you have just given birth, bring help, especially if you had a c-section because you aren’t supposed to be driving or lifting!
4) Hydrate! Make sure your baby is well hydrated prior to the draw, because they will bleed better.
5) Soothe them. Be prepared to offer the breast or bottle immediately following the draw, because it will comfort the baby and probably make you feel better too.
6) Strategize. If you can, find out when the lab isn’t as busy. If you find a phlebotomist that does a good job, don’t be afraid to ask for them again. Ask what their schedule is so you can come when they are working. Be assertive without being aggressive when requesting things for your baby. It was difficult for me initially because I didn’t want to hurt anyone’s feelings or cause any issues, but at the same time, if there was someone who had a terrible time sticking a kid, I didn’t want them again. It took a while for me to find my voice so to speak, but I did. I was kind and polite every time we were there, though, and learned to say things like “it seems like you are having a hard time finding a vein, would you mind asking your colleague to come help because I don’t want him stuck too many times” (insert forced smile). Now, we have friends at the lab who adore our kids. You will be doing this a lot, so these people will see your kids more frequently than some of your relatives so it’s beneficial to build relationships.
As your child ages, they will move from heel sticks to vein sticks. Here are my tips for toddlers/preschoolers and up:
1) EMLA aka lidocaine cream. This is a prescription numbing cream and it is a miracle. The lab we go to won’t administer it, so our pediatrician wrote us a prescription for it. We went to their office the first time we used it, so they could show us how to apply it. We use a pea sized amount only where the vein is stuck and cover it with tegaderm. We buy the tegaderm online (pediatric size works best) but if you can’t get pediatric size, regular is fine – just cut it in half. The tegaderm keeps them from messing with it, licking it, etc. on your way to the lab. We apply it at home and then their arm is numb in that one spot when we arrive at the lab.
2) Remain calm. I know I said this before, but around 1-2 years old, my kids started freaking out when we arrived at the hospital. We would literally drive up and they would start screaming. It was a whole new level of me having to keep calm and take deep breaths. I explained to them why we had to do it, but kept it short and sweet: “you take medicine every morning to help you grow, the Dr wants to be sure the medicine is working, they take a little bit of blood out to look at it and that’s how they can tell if it’s working”.
3) Hold them. Yes – hold them and hold them tight. Once they are too big/strong for heel sticks, they will need to lay down and probably have to be restrained in some way. I have heard of people saying they would leave the room, because they couldn’t take watching their kids be so upset. I feel differently. I would rather be the one holding my kid down than some stranger. At times, I nearly had to lay across my kids to keep their arms or legs from flailing, and sometimes I needed someone else to help hold them, but my face was always the face they saw. If anyone else helped hold them down for the vein sticks, they had to be at their feet. Once my kids moved past the kicking phase, I talked the lab into letting the kids sit up in my lap, and I would wrap my arms around them like a seat belt almost. I still do this with my 3 year old. He is almost ready to sit by himself but not quite. [This isn’t for the faint of heart, but it’s what we have to deal with as parents of children with congenital hypothyroidism. For those of you with infants, I am sure this seems terrifying, but it’s just a phase and before you know it, they are sitting in the seat by themselves with no tears.]
4) Treats. When they were toddler aged, I often brought dollar store trinkets wrapped in cool wrapping paper. I had the presents stashed in my diaper bag, and they would get to open them right there in the waiting room of the lab. Now, we just go to McDonald’s for a milkshake after every draw (because we rarely go there, they see this as a huge treat).
5) Let them watch you. If you ever have to get your blood drawn, let your child go with you and watch you have yours done. Watching you experience the same event is helpful (just like how the parenting books say kids learn to go potty by watching their parents or siblings go potty) especially when they see how you aren’t scared. Just remember not to pass out when your kid is there! This is also my only caveat to the don’t bring your other kids rule – if there is an older sibling who also has to have blood draws, they can be a great role model for their younger siblings. My youngest son has had a way easier time with blood draws since watching his big brother be such a pro at it.
So, this is a lot of information and perhaps overwhelming, but I hope helpful. I now have a 3 year old and 7 year old who do not even shed a tear at blood draws. I credit this to the EMLA, which takes away the pain, and my ability to stay calm and be strong for them. They have become brave, strong little boys because of this condition, so that to me is a silver lining. For those of you who have also survived multiple blood draws with kids, please share your tips! Thanks!
By Blythe Clifford