"Mommy Call the Doctor!"

. February 12, 2013.

Could your child win an Oscar for best portrayal of a sick kid? What to do when you think you’ve got a little hypochondriac on your hands?

My youngest daughter has long been a frequent visitor to the school nurse (tummy aches). And, to the first-aid box in our hall closet (microscopic cuts). And if a little friend comes down with an intriguing ailment (walking pneumonia was the latest one) my daughter is likely to limp dramatically and claim that she might have it too.

Turns out, many kids go through a “hypochondria” phase around age five or six — just as they’re getting used to being in school full-time and separating a bit more from Mom and Dad, says Michelle Macias, M.D., a developmental behavioral pediatrician at the Medical University of South Carolina, in Charleston. This period is a major transition, she explains, and anxiety often peaks, revealing itself in symptoms like a sudden sour stomach or mysterious headache. “Many kids this age can’t express uncomfortable feelings in words, so they express them through their behavior by ‘feeling sick,’” says Dr. Macias. (Fortunately, few kids are true hypochondriacs, which is actually a clinical term for a much more serious disorder.)

How do you separate real health crises from the imagined ones? And should you offer your dramatic limper and bandage-collector extra hugs — or a blind eye?

Your child cries wolf. So much so, that you’re concerned you’ll miss the clues when he actually is sick.
 Treatment plan: If your child is ill, you will know, says Dr. Macias. He’ll have clear symptoms (like fever or vomiting), won’t be interested in doing his favorite activities, or will just look “off” to you, the person who knows him best. If you’re still unsure, it’s okay to let him go to school and see if he improves. It’s also reasonable not to send your child to school for a day, if you can, in order to keep an eye on him. Just don’t make the day at home too pleasant, says Penny Donnenfeld, Ph.D., a private-practice psychologist in New York. “Encourage him to rest quietly,” she says. The bottom line: If sick days are too much fun, your child might angle for more of them.

Your child actually is hurt or sick, but the excessive antics (non-stop sobbing, pleas for fresh bandages and special treatment) are driving you nuts. Treatment plan: “Children like this usually just want you to acknowledge they’re feeling pain,” says Sandi Delack, R.N., and President of the National Association of School Nurses. Saying, “Wow, that really hurt” and giving your child a kiss on the injured spot says, “I care what happens to you.” But once you know that she’s absolutely fine, shift the focus to admiring her abilities and do your best to ignore the ongoing dramatics. If your child regularly begs for extra bandages or an arm sling, briefly indulge her fantasy with a silly “what-if” discussion: “If your arm were in a sling, would your teacher or the principal have to carry your cafeteria lunch tray for you? How funny that would be!” This kind of imaginary talk will help get the “want” out of your child’s system.

There’s no chance your kid is sick. Why is she faking it? Treatment plan: Actually, she’s probably not. Your child may be anticipating something she finds stressful, triggering a stomachache or headache. Young kids don’t always realize or verbalize their worries about an intimidating schoolmate or a sibling who’s getting more attention, according to Dr. Donnenfeld. Instead, they’ll simply “feel sick.” A good way to sleuth out what’s bugging your child is to play the “High-Low” game. Every day, each family member shares both a good (high) and not-so-good (low) moment
from his/her day. You’ll get clues about what’s worrying your child. Also, be sure to keep in touch with your child’s teacher or the school nurse. These pros may have insights about her friendships, schoolwork, and what’s happening on the playground.

When your kid hears someone is sick, he’s convinced he’s next. Treatment plan: “This behavior may be a sign of anxiety,” says Dr. Donnenfeld. It’s likely that your child is becoming aware of “bad things” happening in the world, and may go through fearful stages. Education and reassurance can help. Stress that if he were ever truly sick, you would take him to the doctor. Also, consider how you would handle health issues: Do you nervously whip out the antibacterial gel when your child’s hands are even slightly dirty? Do you often talk about the dangers of the flu or whatever is in the headlines lately? You could be transmitting a “health problems are terrifying” message. “If your child’s worry persists for more than a few weeks, see your pediatrician,” says Dr. Macias. “He may need to learn self-soothing techniques (see “Less Stress, Less Sickness,” below) or, if he has more persistent and significant worries, even get short-term counseling.

Teri Cettina is a freelance writer, mom of two daughters and Parenting magazine contributing editor.