Involving your toddler in the process of taking blood spots samples from this early age helps them to develop the skills needed for taking them in the future. Toddlers need (and like!) routine and predictability, so having a similar process each time you take a blood spot, will help them to acquire these skills.

Processes which involve familiar items, such as a special chair, familiar surroundings, such as a view near a window, and/or a familiar “after” routine, such as a cuddle or reading a favourite book, always help to build the most confidence in young children and set them on the path for positive future habits.

The frequency of blood sampling depends on the age, and PKU control of the individual. Children generally need to provide blood samples more often than adults.

There may be times when your child is reluctant to have a blood sample taken. If they usually have no issue, then it may be an early sign of illness, so try and be calm. If there appears to be no reason to their reluctance, the following tips may help.

• Tell your child why they are having their blood taken. Explain to them that taking this sample will help them feel good and be able to do the things they enjoy, like playing with their toys and running around the park.
• Talk them through what is going to happen when you take their blood sample – this way, they know exactly what to expect.
• Show them what will happen by completing a blood spot sample of your own (ask your nurse for some spare blood spot cards).
• By completing a blood spot card yourself, this will show your child the correct way to fill the circles on the card. For a reminder of how to provide a good quality blood spot sample, refer to the information ‘Blood Spots for Phe Monitoring’.

Another idea is to use a favourite teddy or doll and pretend to take a blood sample from them. Do the blood spot sample for your child, in exactly the way you have explained it will happen.

Suggesting you need them makes them feel important to the process.  

• Ask/have them to choose a place to store the sampling equipment.  Enforce they are responsible for getting them, when it’s time to take a blood sample. 
• Ask your child to choose where they would like to have blood taken from – their finger or thumb. This will make them feel more in control of the process and their reluctance may be forgotten.  
• Other suggestions for involving your child include- 
• Have them tell you when the sampling card has blood on it.  
• Once you have finished collecting the blood ask your child to cover the prick site with a little cotton wool and apply light pressure for a few seconds. 
• Ask them to pack up the sampling equipment and return it to its’ special spot.  

• Your child may be scared the “needle” is not clean.  Have them wash their hands before sampling, each time, and have them instruct you too!   
• Is the sampling process painful?  Encourage your toddler to warm their fingers and thumbs by rubbing their hands together before taking the sample.  Cold fingers/thumbs can make the prick slightly sore.   
• Ask your child to hold their hand down towards the ground.  This ensures blood is flowing to the fingers before the sample is taken, making sample collection quicker and easier.  
• Try pricking the side of your child’s finger/thumb rather than the tip.  This may keep pain to a minimum. 
• Are you feeling relaxed? Remember to stay patient and calm, this will help your child to also relax. 

• Remember to give lots of praise when your child completes their blood spot sample. This reinforces good behaviour and helps to develop independence.
• Try using a reward chart; place a sticker of your child’s choice on the chart, each time a sample is taken, without issue. Try increasing the incentive for good behaviour by offering a “bulk sticker” reward, such as, once four stickers have been placed, a special outing or a small, non-food related treat will be provided.
• Involve your child in the posting of the sample card. Make this a fun time; play a game on the way to the post box such as “eye spy” or “spot the landmark”. Let them be the one to pop the envelope into the post box so they feel very grown up!

• Try and complete the blood spot sample in the same location, by the same person/people each time. It can be useful to include another parent or caregiver in the process for support and consistency.
• If your child is reluctant, and likely becoming upset, you may be tempted to skip the blood spot sample. However, make it clear the sample must be taken. Allowing your toddler to “have their way” will teach your child that by being upset gets them out of a situation they would prefer not to face.
• Sometimes, distractions can be useful; for you and your child! Children often feel less discomfort and stress if they count, sing, hug a toy, and/or think of something that makes them smile, when involved in something they don’t enjoy. Try one (or more!) of these when they are having a blood sample taken.

Need more help?

If your child is especially upset and afraid of having their blood samples taken, speak to your metabolic clinic nurse.