Some of my least favorite Mom moments are at the intersection of my roles as mom and physician. I work hard to be “just” my kid’s Mom when they are sick or injured but it’s impossible to completely separate out the pediatrician part of me. We most recently landed there when I got a text from my husband at work that our oldest had cut his head. Remember that old “No more monkey’s jumping on the bed” song? We’d arrived. He was jumping on his bed and cut a nice gash in the back of his head. At first, it looked like more of a scrap, but as time went on and the afternoon’s snow continued to fall it became apparent that it wasn’t going to stop bleeding and we were off to the doctor for stitches. Thankfully, our little guy did a wonderful job, but it left me with a brain freshly full of tips for stitches and other painful procedures – from both the pediatrician and the Mom in me!
- Skip the snacks. Broken bones and even some large cuts, can require sedation for repair. Your kid may not, but the last thing you want is to be stuck in the ER a couple extra hours because of a handful of Goldfish crackers and a juice box. Even without sedation, a child with a full stomach who is upset about stitches may puke. Stay away from food and drink until you are done.
- Be honest, but not too honest. Kids, especially bigger kids, know innately that fixing things like big cuts and broken bones are going to hurt. Lying about it changes nothing. On the other hand, you don’t want to oversaturate them with grotesque details. Keep is simple. “The doctor is going to put some special bandaids in your cut so it stops bleeding”. For stitches, the lidocaine is the worst part. The child life experts I’ve worked with usually describe it to kids as a bee sting or a pinch. My child’s never been stung so I went with a pinch. Emphasize that though that part hurts, other things won’t hurt afterwards.
- Warn them before anything happens. The unknown is a scary thing and a simple heads up can be a lifesaver. For example, if the doctor is going to wash their cut with betadine, you can explain that they are washing the cut with cold brown soap. (Brown soap!). Irrigation, covering the area with sterile towels and shaving hair are all things I’d give them a heads up about right before it happens.
- Distract, distract, distract. Once they get down to the actual stitching or casting, there’s really nothing else to explain. It’s time to hold still. Really still if possible. Tell stories and invite your kid to make up the next line. For us it was dinosaurs. He could pick if we were telling a story about a big or small dinosaur, red or yellow, hungry or full – you name it! If there’s a TV available, that works. Let them play games on your phone if it’s okay for them to move their arms.
- With that said, don’t be afraid of restraints. Some kids are too young or too scared to hold still. Stitches near the eye are particularly hard because the kid can see you. If the doctor wants to swaddle your kid up or use a papoose board (basically a giant swaddle), stay upbeat and explain to your kid that it’s a big hug to help them hold still. Sometimes you can be the holder too depending on the situation, but don’t forget #6.
- Take care of yourself. If you feel woozy, sit down. Take deep breaths. Count backwards. Don’t look if blood makes you nauseous. There are no heroes here and you passing out will complicate the whole mess. I’ve put countless stitches in other kid’s heads and I got nauseous with my son’s. It happens to lots of people.
- Reward them. The best rewards our kids get are verbal praise and hugs and kisses. Keep it flowing. “I like the way you’re sitting still”, “Great job letting the doctor look at your cut” and so on and so on. If there was ever a situation for a bribe, this is it too! Whether it’s a special snack or a toy from the store, throw that bribe out there and follow it up. We are now the proud owners of a new Mack truck. For that matter, pick up some ice cream for yourself. This parenting stuff isn’t for sissies!