Clinical Tip: Enlist parents to show their children how to take deep breaths

Every pediatrician knows the difficulty of getting young children to take deep breaths during the stethoscope exam. Some doctors use a bubble wand, or instruct the child to "practice blowing out birthday candles," but I find that the pursing of the lips during the blowing action can distort the quality of the exam by adding noise artifacts to the expiration. My strategy is simpler: I ask the child to watch mommy or daddy, and enlist the parent's aid as a demonstrator by having them take deep breaths with their mouths open. The act of making eye contact with the parent usually focuses the child's attention and calms them. They are surprisingly obedient when mom or dad is demonstrating what to do. This little strategy is easy to remember, doesn't require props, and I have found it to be quite effective.

Kristen Walsh, MDMendham, N.J.