1 (edited by njmomma 2013-04-24 16:47:29)

Topic: Venipuncture for a 1 year old?

I had a 1 year old checkup for my daughter yesterday. The pediatrician told me to go to the lab to get my daughter's blood drawn to check for lead and anemia. She told me its a standard procedure and its done for every single baby. When I asked her if its a finger stick, she said that they will take blood from her vein, not her finger.
I was not too happy about it. I don't think my daughter has anemia or lead posioning. And it seems to me that she is way too young to get her blood drawn from her vein. I can't see any of her veins, and I know it is more difficult to do a venipuncture on a young baby. Plus I have horrible veins, and according to my multiple experiences with venipunctures, techs kept on sticking and sticking me and kept on missing my veins and I always got bruises after venipunctures from multiple unsuccessful attempts.
Anyway, I still went to the lab (all shaken and scared for my baby) that was in the same building as my ped's office. The phlebotomist was not a friendly guy. He basically told me to sit in a chair with my daughter, restrain my daugher, by holding her arm still, while she will be screaming and kicking, and that he will take 2 vials of blood from her vein.
I could NOT bring myself to do it. I CAN'T keep on holding my daughter's arm, while watching another person inflicting pain on her, and restraining my daughter for that particular person. I just can't. Plus I don't think that tech had any special experience with babies, it was a lab for everyone (many other practices in that building). So when he told me that all babies have to do it, I told him that Not MY baby, then I got up from the chair with my daughter and walked out of the lab.
So we didn't get any blood drawn from her vein yesterday. I know my ped will give me a huge lecture on it, next time I will see her.
Did anyone here refuse venipuncture for a young child, if you don't think that a child have health problems? Is a venipuncture really necessary, why can't they do a finger stick instead? Is it just me that thinks that it can be a traumatic experience for a child (by getting restrained by her own mother, while some stranger hurts her by poking her vein with a needle and there is a good chance that he will poke her few times if he can't find a vein right away)? Or is it just more traumatic for a parent than it is for a child?

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2 (edited by old mama 2013-04-24 16:45:51)

Re: Venipuncture for a 1 year old?

I wouldn't have done it either...no medical tests or procedures unless there is a very specific medical condition that warrants it. I have never even had a dr. suggest one of these in a baby. At WIC clinics they do a finger stick for iron. With an older disabled  child with epilepsy we were at a big city hospital lab and we got a tech too that was rough and after the second stick I walked out with my daughter...she was screaming and the tech totally unnerved...after that a nurse in the dr. office did the blood draw.

3 (edited by coryandamanda 2013-04-24 17:02:48)

Re: Venipuncture for a 1 year old?

Ours was done with a finger prick for those tests.
If my child had an illness where the blood was necessary to help them, then by all means I will hold my child down and keep them as still as I can so it can be over as fast as possible.  I just had to do this for the first time with my own child (for H who is 3) and it is heartbreaking but not completely torturous.  We went to the hospital to have it done at the lab there and requested a pediatric nurse or a NICU nurse to be sure we had the best chance of it being successful on the first attempt.

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Re: Venipuncture for a 1 year old?

I'm really not sure why they need to actually draw blood from a vein instead of just pricking her finger.  My son will get his done at 1 year at the health dept, and they've already told me that it will just be a quick stick in his finger.  I guess every place does it differently.  And 2 vials??!!  That's ridiculous!

Anyway, if it were me, I wouldn't skip it, but I would find a different place to go get it done.

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Re: Venipuncture for a 1 year old?

Good job mom!  It is your right as a parent to refuse labs, and as a nurse, I would have made the same decision.  They HAVE NEVER taken blood from my sons veins in all his 2 years.  He's even had tubes and seen a gastroenterologist.  Every test has either been a finger or heel stick.  I think they can do a CBC which should let them know about anemia from a finger stick and capillary tube.  I'm not sure why they want to test for lead unless they believe the baby might have been exposed???

6 (edited by SPJ&E 2013-04-24 17:14:04)

Re: Venipuncture for a 1 year old?

At our old peds office that's how they did the testing as well. I allowed it one time because I was stupid. After that I said never again. You can refuse anything. They hated me at the lab after that...I always made them take it from a finger. They CAN do a finger poke and milk out enough for what they need. They just don't like to necause it takes longer. Good for you for saying no!

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Re: Venipuncture for a 1 year old?

Same type of situation happened at our 1 year checkup. I thought it was a heel or finger stick until it was time to do it. I let them try once and they didn't get it so I left. When she was 4 or 5 months she had a slight fever so they ordered blood work. It was an awful 4 hour ordeal with multiple people trying. I was sent to the hospital because they said there were people who specialize in babies. They couldn't do it either. At the first lab they actually got a vein but the woman pulled the needle out by mistake with her ring. I still get mad thinking about that. So anyway, yesterday we had her 15 month checkup and I told her I didn't get the tests done and she printed the orders to take to the hospital. Now I'm also torn because its the same place that couldn't get a vein before. If they're going to be having these tests be standard procedure then I wish they would have someone available who at least has experience with babies. The girl who was in charge at the hospital when we went at 4/5 months asked if M wanted a juice box and tried to give her silly bands(rubber bracelets). When i said she was too little she said oh I don't know anything about babies! Clearly.

Re: Venipuncture for a 1 year old?

Wow blood from her veins just to check iron and lead levels? With all both my kids and my niece an nephew it has always been a finger prick. I don't understand why that isn't sufficient for your ped. I would've refused it as well. Good for you!

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Re: Venipuncture for a 1 year old?

One of the little boys I nannied for before getting pregnant tested positive for lead at his 1 year check up.  While I absolutely agree that you did the right thing I would see about getting the tests done using the finger prick.  He had absolutely NO risk factors for lead posioning (or symptoms), but it is scary.

I have had to do it 3 times with Kate.  The first at 18 months was awful of course but it was a pediatric nurse, she was great and it was over quickly.  The second time was at 3 almost 4 and it was SO much worse.  But the 3rd time took the cake because it was a short time (maybe a couple months) after the second time so she remembered it!  THAT almost killed me, because she knew before it even started what was about to happen!

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Re: Venipuncture for a 1 year old?

I would still have the tests done. I have a friend who has twins and they both were tested. Neither of them had symptoms, but one of the twins had super high lead levels and is going through a lot now because of it.

I guess I just don't think it's that big of a deal. I've had to hold my kids down before and while it's not pleasant, its usually over quickly. AND not to mention I think finger pricks hurt way more than the veins. I personally would rather have my blood drawn then tested via finger.

Re: Venipuncture for a 1 year old?

If you have a children's hospital or NICU anywhere nearby, get it done there! It is like night & day going to a place that only works with babies & kids. They are so good at what they do, it makes everyone else seem like fumbling idiots.

Also they should be able to get plenty of blood from a heel stick if you don't want it drawn from her veins. They had to take a lot of blood from R to check med levels when she was 1-4 weeks old and they always did a heel stick. It sucked, but wasn't traumatic. Then again, a 12 month old is starting to walk and using their feet more, not sure if that makes a difference as far as lingering pain. But from what everyone else on here said, it sounds like a simple finger prick should suffice. Can you do some research on how they test for the lead and why they'd need to go into a vein?

Whatever way you do it, I think it's going to be unpleasant for your baby. But calmly tell her right before the procedure what's going to happen, that it will hurt but it will be over quickly and it's important so she stays healthy. Even if you have to hold her down, at least she gets the message that it is important and that you aren't trying to hurt her. The more calm you stay, the more calm she'll feel. I always sang a little comfort/distracting song to R when she had to get her labs done and that helped me stay calm.

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Re: Venipuncture for a 1 year old?

I live in a high lead town, and all our kids under the age of three get lead testing done twice a year.  Not sure about the anemia test but for a lead test they need about a teaspoon of blood (5ml).  When Moosie was little, they couldn't get her vein on the first try, I think she was about a year, maybe a year and a half, so they did the finger prick and had to keep milking it and re-pricking it to get the amount needed.  The vein draws were and are SO much easier then that one episode was for us!

Haven't read the other responces, but I personally would have done the testing, and I am normally against "extras".  BUT., I have lived with anemia all my life, and it would have been nice to know and treat as a child rather then discover it as a teen when I was already SO low it took IV irons to get them back up.  And living in a high lead town, lead exposure can be extremely harmful for brain development.  Lead exposure also doesn't show up as lead poisoning until it is far too late to treat.  All three of my kids have had high blood lead levels as toddlers, but within the "normal high" range, without testing I would not have known what steps to take to keep it in the normal and even bring it back to the low range.

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13 (edited by HopingForBFP 2013-04-24 19:01:26)

Re: Venipuncture for a 1 year old?

Sydnee had one at 9 months. I was so surprised. But she handled it like a champ. Didn't even cry or quirm. Luckly it's been finger pricks from now on though. She doesn't even cry for those either. I think the finger pricks hurts the worse though, I hate them!

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Re: Venipuncture for a 1 year old?

Our son had that done at his 12 month well visit and it was a finger prick. I don't like the idea of drawing blood on a baby. Our daughter had to be sedated and get an IV when they performed an MRI of her head and I hated that idea but went along with it because it was necessary! I wouldn't have let them do it.

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Re: Venipuncture for a 1 year old?

They told me the reason they switched to a vein draw from the finger/heel prick was because they were getting a lot of false positives which caused people to have to come back for the draw. Insurances didn't like having to pay twice for the procedure so they just started doing a draw on everyone. The idea of going to a nicu/pediatric ward is great but our hospital won't let you. I asked and they said it wasn't an option, even after all the sticks when she was 4 months.

Re: Venipuncture for a 1 year old?

You don't go to the ward, you go to the lab and have a person sent down from the ped or nicu.  You might have to wait, but it is worth it IMO.  If you have to spice up the truth to have them cooperate, then do it.  Tell them the last time you had it done it took 5 tries and your kid cried so hard she puked all over the lab tech.   Believe me, they'll call up to the floor for help big_smile

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Re: Venipuncture for a 1 year old?

Lol I did try that. We were there for about 3 hours, I asked to have someone sent down and they said they don't do that. I'll ask again this time though

18

Re: Venipuncture for a 1 year old?

I would definitely do the tests. I, like Shanny, have had a nanny kiddo with lead issues and it is not something you want anywhere near your child.
Ask for numbing cream for her arm before the stick and she should be able to stare right at it and feel nothing.

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Re: Venipuncture for a 1 year old?

I am agreeing with Goobie.  If you are going to do the tests, a vein stick is much easier on your baby than a prick and milking session.  I trust myself to gently hold my baby rather than a stranger.

Re: Venipuncture for a 1 year old?

Thank you everyone for your replies and sharing your experiences with this.
I would still rather do a finger prick instead of the vein, and mainly because it is more difficult to find veins in a very young child and there is a good chance that they will have to stick her vein few or multiple times instead of just once (especially with a tech who doesn't specialize in babies), and I am absolutely NOT willing to put her through this. If anything I would just have to find a different doctor (that will agree on the finger prick), which I don't mind, since there are many other issues that my pediatrician and I disagree on anyway.
Klt86, I am so sorry your daugher had to go through this. I hope you get very good and experienced NICU or Ped nurse and it will be very quick and painless.

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21

Re: Venipuncture for a 1 year old?

Chiming in a little late but anytime you don't feel comfortable with a procedure or treatment for your child, you should walk out.  That said, the whole thing was (and will be in the future) more traumatic for you than the baby.  It's a quick 1-2 minute blood draw with pain that's over as soon as it's done.  The more calm you are, the easier it will be on her.  I did this with Shiloh at that age.  She was fine until the stick and even then it took a few seconds for her mind to process that there was pain.  Crying stopped as soon as I turned her to face me and cuddled her!

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22 (edited by Jccwill3 2013-04-26 17:49:31)

Re: Venipuncture for a 1 year old?

EDITED FOR SPELLING: Sorry to say this but I know, even now I'm TERRIFIED of just having my finger pricked. Drawing blood... no problem. But that fingerstick is the worst pain of my life. My mother said she had faced the same dilemma -- but that goes to show it can go either way.
When I was an intern, I was drawing some blood by fingerstick and I was like "Okay, take a deep breath, IT wont hurt." Naturally, instead of pricking the patient, I pricked myself : "SON OF A BIT-- .... "Oh, well, even though I'm bleeding profusely it still doesn't hurt. Can you excuse me?" ::FAINT:: Believe me, that venipuncture might be far less traumatic.

Re: Venipuncture for a 1 year old?

Chiming in late also.  I agree with Zen completely.  No one can force you to do any treatment on your child you are uncomfortable with - totally your right.  But that being said, I agree that it is way more traumatic for the parents than for the baby.  It sounds to me like you are extremely uncomfortable with blood draws for yourself and you are projecting that on to her - understandably so.  But honestly, the worst part of blood draws is the anticipation.  I hate that part too.  But te needle stick itself is no worse than a finger prick, and actually I find finger pricks more painful myself.  For a baby, as long as you ate calm, the anticipation is non-existent.  They have no idea what's coming.  It hurts temporarily, and fairly minorly, and then it's over.  And honestly I have seen them get newborns veins fairly effortlessly.  Although he doesn't do only infants, I'm sure he sees them every day since the pediatricians are there.  Personally I will have the test done.  I won't love it but I know it will be over soon and he will be fine.

24 (edited by njmomma 2013-04-26 21:06:42)

Re: Venipuncture for a 1 year old?

Jccwill3 wrote:

EDITED FOR SPELLING: Sorry to say this but I know, even now I'm TERRIFIED of just having my finger pricked. Drawing blood... no problem. But that fingerstick is the worst pain of my life. My mother said she had faced the same dilemma -- but that goes to show it can go either way.
When I was an intern, I was drawing some blood by fingerstick and I was like "Okay, take a deep breath, IT wont hurt." Naturally, instead of pricking the patient, I pricked myself : "SON OF A BIT-- .... "Oh, well, even though I'm bleeding profusely it still doesn't hurt. Can you excuse me?" ::FAINT:: Believe me, that venipuncture might be far less traumatic.

In my life I had both, multiple finger sticks and many venipunctures. So I am very familiar with the pain that's associated with both, so the quesion was not really about that. However, I know that babies have smaller veins and their veins are much harder to find. So I asked parents here about their experiences with their babies for that particular test, and I  was really glad to find out that they still do finger pricks for that kind of testing and btw as a nurse, I was glad that nurses here that replied to me agreed with me on the finger stick.

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25 (edited by Jccwill3 2013-04-27 09:41:05)

Re: Venipuncture for a 1 year old?

njmomma wrote:
Jccwill3 wrote:

EDITED FOR SPELLING: Sorry to say this but I know, even now I'm TERRIFIED of just having my finger pricked. Drawing blood... no problem. But that fingerstick is the worst pain of my life. My mother said she had faced the same dilemma -- but that goes to show it can go either way.
When I was an intern, I was drawing some blood by fingerstick and I was like "Okay, take a deep breath, IT wont hurt." Naturally, instead of pricking the patient, I pricked myself : "SON OF A BIT-- .... "Oh, well, even though I'm bleeding profusely it still doesn't hurt. Can you excuse me?" ::FAINT:: Believe me, that venipuncture might be far less traumatic.

In my life I had both, multiple finger sticks and many venipunctures. So I am very familiar with the pain that's associated with both, so the quesion was not really about that. However, I know that babies have smaller veins and their veins are much harder to find. So I asked parents here about their experiences with their babies for that particular test, and I  was really glad to find out that they still do finger pricks for that kind of testing and btw as a nurse, I was glad that nurses here that replied to me agreed with me on the finger stick.

I agree with PP, I was just sharing anecdotal information. I say, whatever you are comfortable with as a parent is obviously your choice. Usually the have a good peds phelb. nurse on hand, but if not, I say trust your instinct.

26 (edited by Phlebitis 2017-10-19 19:52:45)

Re: Venipuncture for a 1 year old?

I know I'm necroing a 4 year old thread. First off Hello all! I'm a certified phlebotomy technician(CPT).  A 1 year old child should not be getting a venipuncture. We're not supposed to use venipuncture on anyone younger than the age of 2 years old.
 
    If we do use venipuncture on some one that young, there are very specific protocols we're supposed to follow. Some one that young doesn't have alot of blood in their body, so we have to be very careful how much we take and it's supposed to be  documented. You could literally kill an infant child if you draw too much of their blood. Not only this but it's very easy to cause damage to the surrounding tissue around the vein. Main concern being nerve damage.  These are reasons why we generally do not use venipuncture on anyone younger than two years old.

  I had a 2 month old baby come into the clinic today. They ordered a bundle of tests and wanted it done by venipuncture. On a 2 month old child..... We refused to do it. Me and my coworker did a heel stick instead.  Never be afraid to refuse any medical procedure. You have rights, and you can refuse any medical procedure.

So I know I necroed this thread, but hopefully some one else will see this post. If some one wants a venipuncture performed on your child younger than 2 years old, I do not recommend that you allow it. If you do, find some one who specializes in pediatrics. While a blood draw seems like a simple procedure, it can be fatal in a infant.