Practical Pointers - Eyedrops, Deep Breath, Earache

Editor’s Note: Consultant for Pediatricians welcomes your contributions to “Consultations & Comments,” such as the pediatrics pointers your colleagues offer below. Send your pointers, letters, questions, and other brief correspondence to managing editor Michael Gerchufsky, CMPP, ELS, at


In the Blink of an Eye

Putting drops in a child’s eye can be a struggle, but it might be easier if you follow this suggestion: Have the child lie on her back. While her eye is closed, instill one drop in the corner of the eye. Have her blink, and the drop will run in … in the blink of an eye!

“Blow Out the Candle”

Trying to get toddlers to take a deep breath when auscultating their chest can be challenging. I hold the otoscope light in front of them and ask them to “blow out the candle,” like on a birthday cake. Their natural inclination is to take a deep breath and blow really hard. This works every time.

Anthony Titus, MD

Wilson, North Carolina

To Ease Fears, Mommy Goes First

When a parent and child both arrive for a medical visit, it helps for the parent to be “examined” first. Such a sequence of events gives the child a chance to observe his mother or father undergoing the examination in a relaxed and comfortable manner, and helps the child to see the pediatrician as a nonthreatening, friendly figure.

You Open Up, They’ll Say “Ahhhh!”

Opening the mouth for an oral examination is not always easy for a small child. I find that the best thing for the physician to do is to open his or her mouth as wide as it will go, putting up a good example. Children tend to instinctively imitate everything and everybody, and this gesture very likely will evoke a favorable response.

Earache Diplomacy

A 3½-year-old toddler is sitting on her mother’s lap, ready to be examined for a left-sided earache. The girl is almost ready to cry, because she is afraid of doctors. In this case, the painful ear should be the last to be examined, with a general detailed examination as an introduction to the visit. The extensive examination will serve to produce a mental image of the doctor as being gentle and painless, and possibly produce a smile or laugh on the face of the patient, making the eventual examination of the painful ear much more agreeable. Parts of the general examination, such as examination of the abdomen and the knee and plantar reflexes, also may be used to augment the patient’s comfort level.

Basil Rodansky, MD

Woodhaven, Michigan