Thursday, January 31, 2013

Well-Child Check-Ups: How We Do Them Large Family Style

You may be reading this post for ideas for your own family.  You may be reading it just out of curiosity about large families.  *smile*  But most of you I've talked to are surrendered to the Lord in your family planning, have 2-5 children so far, and are eager for a vision for how doing practical outings like this can work with a large family in the future.  I hope this latter group especially is encouraged that doing things like this can be pleasant, do-able, and I hope you then feel all the more courageous to continue following the Lord's plans for your family.  *smile*



Here's my story.  I have always needed to be creative and make a way to take all of our children with me to the pediatrician for "well-child" check-ups as I could not afford to hire a sitter as often as I needed to do this.  *smile*  The older kids go annually which is frequent enough already with 9 children, but with newborns I followed the pediatrician's recommended schedule which meant very frequent visits (newborn, 1 week, 2 week, 3 month, 6, 9, 12 month); and until these past 2 years we've pretty much always had a newborn!  *laugh*  It's one of those real life things that we do.  To those of you who think that it would be impossible, in my opinion it's not a big deal really.  It is time consuming, yes, but not difficult - with a plan.  *smile*  

I have simply adjusted as we've gone along in life, first with bringing only one child, then two, then three, etc., coming up with strategies as we've grown to enable me to do this common outing as easily as possible.  Having a plan helps me to step away from the fear or worry of a situation and instead to be logical, objective, strategic, and creative.

In this post on organization for pediatric visits I will share with you:
  1. How I would take just a few children in the beginning
  2. How I took all 9 children
  3. And how I can do appointments now having slightly older children
I hope this will give you some ideas for taking a smaller family to the pediatrician's office, give you vision for how it is very doable to take a bunch of children, and hopefully give you something to look forward to in having older children eventually. *smile* Where there's understanding and vision there is not fear. God always has a plan, and He loves us and desires for our success and peace in what He's given us. So when we ask Him, and learn to listen to Him, He is always faithful to lead us.

1. Well-child check up's with a few kids
I have always used strollers to help young children be successful and safe when in public, especially when there are many young children very close in age. This way I was free to get them all in to the building safely from the parking lot or parking on the street, I was free to use my hands while at the check in counter and focus on what the doctor or nurses were talking to me about with out having to manage the children, and I could easily bring everything we needed with me without carrying it all.  Things like the diaper bag, bottle supplies, snacks, coats, and a small activity for an older one if an activity was not already going to be available at the office.

Our first two babies were only 13 months apart, so I would use a double stroller for both babies when we were out.  When our third was born there was a three-year gap between him and our second child, so I only needed a single stroller and had the older two girls, ages 3 and 4, walk with me.  

Side note:  If these older ones had been boys, however, based on my experience with the boys we do have, I have no doubt that I would have still used a double stroller for the baby and the 3-year-old and had as few little boys to manage outside of a stroller as possible.  *laugh*  For me, gender has also been very much a determinant of when and if I need to use strollers.  The girls were not perfect of course, just much more inclined to be attentive, close to me, quick to listen, and physically compliant; boys, as precious as they are, have pretty much always been stronger in every way (attitude, desires, determination, physical strength), and strollers have been mandatory for me to be able to manage every one by myself.  

I also did a great deal of character training at home in every day life, before expecting children to do well when in public.  But managing many young children very close in age has many different aspects to it than other people have to deal with.  I am all for educating one's self on becoming a better parent.  But if one has this dynamic of number of children and the ages of those being really close, then what the books and classes teach rarely directly applies as it is, in my experience.  What the books and classes teach has to be tweaked to fit this different dynamic.  I've spent a lot of time feeling frustrated over the years because what the books and classes recommend didn't work for me, until Bob helped me to see that the principles taught in books and classes apply nicely to one child, or children spaced 3 years apart (pretty much then only one child to train).  But they are totally impractical for dealing with lots of "littles".  Still good to learn - but remember to take them "with a grain of salt" and then adjust them to fit the large family situation.

So while at well-child checks with the three children I would do several things in advance to help the children be successful.  First, I would always schedule our two oldest girls appointments simultaneously since their birthdays are only 1 months apart from each other, but this can be done with any other pairs of children as well.  If siblings do not have close birthdays then I would just either pick a month in between their birthdays to remember to do it, or just take them both after the second child's birthday (if they're 3 or 4 months apart for example) so that I could simply say to the pediatrician, Yes this child has just turned 5, or whatever (rather than complicating the issue with a child being almost 5 but not technically quiet yet, etc.)  I've always done annual well-child check-ups right after a child's birthday if possible so that I can easily remember who needs to go when.  So doing two or three children's appointments simultaneously did take a little bit longer than with one child, but would ultimately save me an additional trip.   

Second, I would schedule their appointments about a month in advance before they needed it so that I could be sure to get the specific time of day that would be very best for the children and for myself.  A time when I knew the children could be successful in their behavior because they would not be overly tired by missing a nap, their tummies would be full and they would not need to eat while we were there (unless doctors were late, which I did have to prepare for, though), and and we could have the most pleasant and easy appointment possible.  This made the time nice not only for me but for the children, and for the staff at the doctor's office. 

In order to do this scheduling I needed to have a good routine in place for the newborn baby especially so that I could help her feel good and count on what she would need and when.  When our newborns had 2-3 naps a day I needed to work within these times, and within the times of my other two nappers (watch for a future post on how and why we have children nap through age 5), and also in between meals, which meant there was usually only about one time of day when I could take them all easily.  *laugh*  So I simply had to plan way ahead to plan for success.

Third, I prepared not only for what I knew the children would need, but also for the just-in-case situation, and as simply as possible.  For every appointment I brought:
  • A well-stocked diaper bag for baby (for an example with photos see this post)
  • A snack for kids (they shouldn't need it, but if I needed it I had it)
  • A small pediatric appointments carry-along bag (that stayed packed to go to these appointments so I could just pick it up and go) containing two 12-inch spiral drawing pads, one for each of the older kids, a package of Twistables Crayola Crayons (which pretty much don't break), and one large Winnie the Pooh book or Bible stories book that had many stories to be read all from one book.
When we arrived at the appointment and we were admitted in to the patient room, I would park the stroller in the room and begin reading stories to the older two children.  When the doctor arrived the older children knew where I had assigned them a place to sit (on a chair or against a wall) where they would stay for the entire rest of the appointment.  I handed them their drawing notebook and one single crayon to use the whole time.  This way I did not have crayons being lost or broken, stolen from the other sister, or whining to me about wanting a different color.  They didn't need lots of colors, they could draw very well with one.  *smile*  They stayed out of the doctor's way, they were not allowed to interrupt during the appointment and should stay quiet until the end when the doctor would take time to talk with them a bit, too.  

I had compliments from the staff at the office every time we were there about how enjoyable the children were, how well they waited for 45 minutes if necessary, and how glad the staff was to see us again.  Blessed my heart.


2. How I took all 9 children
We have had children 10 1/2 months apart, 11, 12, and 13 months apart, and like I mentioned earlier, using strollers has enabled me to go places with our large groups of "littles" by myself. When our babies #8 & #9 were born (twin girls) and I was taking all 9 of our children to the pediatrician for the babies well-child check ups, the children's ages were:  12, 11, 7, 5, 4, 2, 1, and the 2 newborns.  *smile*  


I still implemented the initial points mentioned above for having appointments successful with only a few children.  I'm an ON PURPOSE mama.  *wink*  And I already had a plan for leaving the house successfully both on time and fully prepared with 9 children for wherever we are going as well. 

By this time I was bringing two double strollers not just the one, two diaper bags, one for the babies and one for the next oldest two boys who were ages 1 and almost 2 (larger diapers, extra clothes for them if a diaper "blow out" occurred, cheerio snacks, and Tylenol for their age rather than the infant Tylenol for if they were teething); and a larger pediatric appointments bag.  The larger bag then contained one large book for each of the 3 "middle kids" (ages 4, 5 and 7), 3 drawing tablets for them, still only one package of crayons to be shared, the 1 and 2-year-olds played with the toys in the office while they remained in the stroller the entire time, and the older two girls (ages 11 and 12) threw in their current chapter book.  But all of our bags and jackets fit underneath the double strollers so we did not have a lot of things to keep track of really.

You can probably imagine that it is very cramped in the room when we're all there.  *laugh* But our clinic does have one room a little larger than the rest and we do fit although snug.  The children remained in their strollers the whole time or in their place on a chair or on the floor.  I can't have them getting in to drawers and cupboards in the office, crawling all around on the floor, getting increasingly noisy, or bickering.  And the rules are always the same for the children when we're there so that they know what to expect every time and they settle right in to the plan.  A plan has never been successful for me if I tried to implement it sometimes and not other times.  It had to be consistent to be successful.  And as it was varying children's turns I would take that child out of the stroller if it was their turn, and then place them back in the stroller when it was another child's turn, not having more than 2-3 children having appointments simultaneously or the time was too long to expect the group to continue to be successful.

It was also helpful by this time to utilize the 11 and 12-year-old girls which was such a blessing, and they did a good job, and enjoyed being productive, experienced, capable, helpful, and important.  They helped to undress or re-dress little ones with me so that the doctor did not have to wait unnecessarily, sometimes helped read stories aloud very quietly to "middle" kids, and helped the 1 and 2-year-old switch activities or pick up one that was dropped.  In this way I could then totally focus on the doctor and the child being checked.

When the appointment was over, before we left we completely cleaned up not only the things we'd brought but also picked up any dropped Cheerios, straightened chairs, etc.  My dad always taught me growing up that we should always leave a place looking better than it did when we arrived, and so we still practice this principle in our own family.
 


4. How I can do appointments now having slightly older children
When one has older children at home it can be even easier of course.  If they're old enough to baby sit, then that totally frees up the schedule for when appointments can be made, and it enables mom to bring only the ones seeing the pediatrician that day.  


If the oldest children are not quite old enough to baby sit a bunch of siblings, then it can work well to leave for an appointment during the youngest children's nap time (and again, our children nap through age 5, so this leaves only an older group of non-nappers to be managed at home).  So the older ones really only need to supervise younger children's activities, and I would even have those "middle kids" doing activities independent of one another so that there are not relationships to manage.  We would call them "play alone time" activities, and have them even in separate rooms.  This kept the house quiet and peaceful for older ones to manage.


If there was one child in particular that needed more of my direct supervision then I would be sure to always take that particular child with me to the appointment, and that child would do what he or she always did when there were more children present, drawing and reading or looking at one book.

If an appointment needed to be made either other than at nap time, or if our oldest children were not quite old enough to baby sit so many children, then another idea is to ask a young lady from church if she would mind coming over for about 1-2 hours while mom takes kids to the pediatrician appointment.  We have had ladies at church who would volunteer to do this as a gift of their time.  I always tried to pay them if I could as their time is valuable, but if it was a tight time of month financially then they were very gracious to come anyway.

 ~ ~ ~ ~ ~

So if you've ever heard yourself say, "I could never have a bunch of kids, because I could never take a whole bunch of kids to basic things like pediatric appointments", I encourage you to reconsider.  Instead, we need to surrender to the Lord's plans for our lives, ask Him for directions as we go along, study His Word and obey what He teaches us...and watch how successful His plans are.  We shouldn't say, "I could never..." and so don't do it; rather we need to say, "I will, Lord; please show me how to do it well."  *smile*  It shouldn't be a matter of whether or not to obey in surrendering family planning to Him, but rather determining that we will obey and then determining how to do it to the best of our ability.  And remember, He promises that He will never give us more than we can handle with Him.


Blessings on your pediatric appointments,

You might also be interested in reading my related posts:
Pursuing a Large Family Mentality When You're Still a Small Family
Large Family Preparations to Leave The House - This, Too, Has a Plan
Scheduling and Routines:  You Can't Have Your Cake And Eat It, Too 
Scheduling Babies

13 comments:

  1. With our first four we did well-child always and on time and our plan was pretty much the same as yours. With the last four we have not. We just did not want to deal with bringing home sickness. Also our peds let us go because we do not vaccinate anymore. Our children now see our family doctor, but they do not have a separate waiting area for sick ones, so we avoid going. We are also in a stage of life that I have a 19 yo who will stay home or in the van and let the others watch a video or color....it is so nice and such a blessing. Thank you for this post. Your family has been such a blessing. I look forward to each post.

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  2. We only have 3 children totake to the ped. (Our oldest goes on his own). I take the 3 boys at the same time. They're pretty good/patient while we're there but the one thing I have learned to do is to schedule us as the first appointment of the day or during a time when the office is slow. That reduces office wait times so we're in and out.

    These day we go for well visit's or shots on Sunday mornings. (yes my ped is open on Sunday-we live in a frum community). We get the first appointment so we're in and out in a flash!

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  3. These are wonderful tips! A little organization, planning, and instruction go a long way. I have 9 children now, and i had a similar strategy when my children were all young. Now, I only do well visits with the family doctor very rarely, if a child has not been sick or needed to see the doctor in a long time. We do these only to maintain a relationship and "current patient" status with the doctor, which is important.

    We have had a more difficult time dealing with those other regular medical visits: Dentist and Opthamologist, as these appointments last much longer. We shopped around and found practitioners open on weekends and willing to schedule 3 appointments from one family in a block. This way, my husband or I can take just the 3 children with appointments. We try to fit one of these days in every other month, so it does not get too tedious.

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  4. Thank you for the advise. Yesterday I was out all morning at a health check up for my 6 month old. And I wondered to myself, "how on earth do large familes manage childrens appointments??" I thought to myself that with all the people and with all the docoters, dentist, health checks etc that large familes must be constantly out at appointments! And then your post came up today!

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  5. Longtime reader but first time commenter here as this subject is near and dear to my heart. As a healthcare provider, all I can say is thank you, thank you, thank you for the hard work you have put into preparing your children for appointments! I promise, it makes a huge difference to the provider and staff and the effort does not go unseen or unappreciated! I have had children play with and break equipment, make messes that aren't cleaned up and left to the staff, run wild, etc. - it takes time and resources away from other patients.

    I always make a point to thank children (and their parents) for their good behavior and tell them it was a pleasure to see them in the office. I let them know it makes my day better - that way they can see that their good actions have a positive effect on others too! Keep up the good work!

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  6. What a timely post! Yesterday I had to take all five of our young children to a last-minute pediatrician appt because of an ear infection, and it was a little bit scary (I don't usually need to take all of our children, but had no babysitter.) Your post gave me some good tips to make this experience better the next time. I totally agree with you about the benefit of leaving a toddler in a stroller. Any tips on how to take all of your children to the library?

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    1. I've had to keep them in the stroller the whole time. If they're out sometimes but not other times, that doesn't go over well at all. I've tried harnesses, but that's too much freedom and temptation to run (of course that depends on the gender/age/personality). And when we were needing to spend 2 hours there to get 80-90 books for all 9 of our kids, then that was too long for them and I started bringing two cube carts on wheels instead of the strollers and leaving little kids at home with daddy while I take just the big kids on a Saturday. =)

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  7. Dear Erika, I discovered your blog a few months ago and am so blessed by it. I look forward to each post, especially in practical living advice! You give me encouragement and hope with my mothering and home making. I am a mom of two- 9 and 8 year old girls. I had a tubal ligation at age 24 and regretted it from day one! Over the past two years, the Lord impressed upon my husband and I that children are a blessing and we need to give him control of this area of our lives. God provided a way for me to have tubal reversal surgery (just last month). We pray that God will bless us with another chance to grow our family- and trust him with the outcome. We pray that our choice will be a strong testimony to God's mercy and grace. Thanks so much for your efforts in writing to moms- I really take comfort in your advice and mentoring! Katie, Wisconsin

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  8. We don't do well child visits all that frequently, more like every two years, and they go fairly smoothly with just our five (now 2-12). I also schedule all five dental cleanings at the same time which makes it a piece of cake to get it over with for another 6 months. I'm sure 9 dental appointments takes a bit longer, though, lol.

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  9. Erika, I have a nearly three-year-old little boy (four other littles too) who has been so whiny and demanding recently. He screams and just pitches a fit when he doesn't get things exactly his way. This can become a bit embarrassing if one of these demonstrations happens in public. I'm getting tired of his whining/screaming/determined fits. He is not coaxed out of them at all. I've tried to redirect his actions/thoughts. I've tried quiet talking (separate from the trigger). I've tried not-so-nice methods. I've even tried bribery. Nothing seems to be working. How do you nip major behavior issues in the bud? What do you do when your child is unruly?

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    1. Consequences for his misbehavior, every time with consistency. But it still may take a year to "cure". *chuckle* Seems like you're doing the right things. And I've needed to just leave that child at home with daddy when I'm out until he's doing better. I had to completely readjust when I shopped so do this, but it's just what is required right now. Oh, and be sure you never reward his behavior when you're out by giving him what it is that he wants (candy, toy, freedom, whatever). As soon as you know what it is that he is demanding, make SURE he does not get it now. And communicate that to him. I say, "I'm sorry, I cannot reward that behavior so now you may not have it at all. I'm sure next time you'll make a better choice in how you sit in the cart."

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  10. I have 4, and the youngest 3 are 18 mo apart. My 2 oldest require regular pediatrician/doctor appointments for special needs (one on a prescription medication) so for me, it is just as easy to schedule well-child appointments and follow up appointments all at the same time. I'm currently expecting #5 (18 months younger than #4!) so I don't expect this to change any time soon. Unfortunately (or maybe fortunately??) I don't drive, so daddy comes with us too, meaning we have two adults. One to watch the others while I'm in the appointment with whoever's turn it is. But yes, plan ahead, bring snacks, bring small toys/games/books. Our doctors' offices prohibit strollers in the waiting rooms, so we don't have that convenience, nor do they provide toys/books any longer (to prevent spread of germs), so we bring all our things, packed in 1 or 2 bags only! Plan, plan, plan and then plan b, usually works for me.

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  11. The Lord has been speaking to me on so many levels through so many different books and sources. He is saying the same thing every time. Your quote sums it up. "I will, Lord; please show me how to do it well." May this be our motto as Mamas. Thank you for you time and your willingness to share.

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