It's hard to imagine now, but before the pandemic, very few of us were concerned about making our kids comfortable with having a very long swab stuck up their noses. But in the age of COVID-19, nasal swabs are definitely a thing. While it is usually more uncomfortable than it is actually painful, it can cause a lot of freakouts for our kids, and unwelcome stress for us adults.
During those first COVID-19 tests, many of us were surprised by just how tear-jerkingly uncomfortable they could be. Not all providers swabbed the same way, and some were more heavy-handed or imprecise than others. The deep nasopharyngeal swabs move toward the back of the throat and must be done by a health care professional. This type of swab sample is associated with the most accurate type of viral test and should not hurt if done correctly. Fortunately, years of experience have since given many providers a gentler touch, and more research and product development has brought new types of COVID-19 tests.
This far into the pandemic, there are now many types of COVID-19 tests, with varying degrees of accuracy. The gold standard is still the polymerase chain reaction (PCR) test, a type of molecular test that detects viral material and must be processed in a lab. Antigen tests, commonly referred to as “rapid tests,” look for a proteinassociated with the virus and are commonly used for self-testing at home, routine screening, and at testing clinics, as they can return results in minutes. Many of these tests permit swabbing in shallower locations at the front or middle of the nose, rather than the back. Some use saliva and are impressively precise. (But for now, the nose swab rules.)
As a pediatric health psychologist, I've spent more than 20 years teaching kids how to cope with medical procedures. No matter which test they take, the good news is that there are simple ways to make the whole process easier on your kids (and you). Here's what you can do to help things go smoothly.
Prep Them
Parents sometimes avoid telling their kids about a medical procedure ahead of time because they think it will make them too nervous. That's a kind instinct, but maybe not the best call—it's like asking them to make the clutch play in a game without ever having practiced the sport before. Preparing your children for what might happen will actually decrease their anxiety and enhance their sense of control.
Before your kids get tested, explain the following to them:
- What the test is. You might say, "It's a pretty quick test that can tell us if you have this virus."
- Why they need it. They may not understand why it's happening. Say, "We need to find out if you have the virus so we can figure out how to best take care of you and keep you healthy."
- How it works. Walk them through it. Say, "They are going to put a swab like a Q-tip up your nose and rub it around for 15 to 30 seconds, about as long it takes to sing 'Happy Birthday.'"
- Where it will be. It could be at home, at a medical clinic, or even in your car.
- How the person will look. Little kids can feel uneasy when they see health care professionals approaching them in masks and/or face shields. Show them pictures of nurses and doctors dressed this way and talk through why they wear that equipment. Say, "This is how they make sure that they don't share germs with you, and you don't share germs with them. Isn't that cool?"
Find a Comfort Position
Like with injections, many kids will need to be reassured when they get swabbed. Comfort positioning is a way of holding them during medical procedures that makes them feel safe, and it is recommended by all pediatric medical organizations. It’s also much better than holding your kid down for a procedure, which years of research shows is a really bad idea that can traumatize them.
For a nasal swab, the best way to position a young child is to hold them on your lap, with their back to your chest. This position allows you to hug them while keeping their hands and arms away from their face. Older kids can sit or stand between your legs. If they are getting tested at a drive-through site, sit in the back of the car with them. Create a calm space and use soothing words as they get swabbed.
Practice Being Still
The key to having a less painful experience when getting swabbed is staying as still as possible. Staying still also helps you or the health care professional performing the test do it correctly. This can be a challenge for kids, especially in an uncomfortable, unfamiliar situation. Make it feel like a game by asking them to picture themselves as statues. Say, "Who can be a statue the longest?" or "Who can be the silliest statue?"
Change Their Focus
Every parent has struggled to get their kid's attention at one time or another. This natural ability to tune out the world proves very useful when it comes to changing the way kids experience pain and distress. Before they take the test, have your child choose something else to focus on, like a video, drawing pad, or a special toy. It will keep their anxiety from creeping up pre-procedure and make the nasal swab go more quickly and easily.
Engage Their Senses
Stimulating your child's other senses at the time of the swab can change their experience of it. Divert them with sensory experiences like music, forehead or hand massage, snuggles from a favorite stuffy, or even virtual reality goggles, all of which can steer their focus away from the discomfort.
Make a Plan Together
Collaborating on a plan can have a surprisingly big impact. When kids get to choose how to handle things, they feel more powerful and less stressed out, so why not let them pick the strategies they want to use? If your whole family is getting tested at the same time, consider asking your child to decide who goes first.
When you get your test done, you can model staying calm and demonstrate your coping skills for them. It's not a terrible idea to also include a reward in this situation. We all need a little motivation to get through challenges, so give them something to look forward to on the other side of that nasal swab.
Acting out what will happen is an especially good idea for younger kids. Finding out what it's like to get a nasal swab ahead of time can help them concretely understand what will happen and how they want to handle it. Much like practice for the big game or the dance recital, practicing builds confidence and reduces anxiety. They can practice with you, on a favorite stuffy, or anything else they want to use.
Remember That Your Energy Matters
Finally, the most important piece of the puzzle is you! Your attitude makes all the difference when it comes to helping your children feel good about the test. Your level of stress is a major predictor of your kid's distress, but the good news is that your calm is also contagious. So take a few deep breaths, relax your shoulders, and find your happy place. Wrap your comforting arms around your child, and remind them it will be over soon!
