Q: How can we make insulin pump site changes less of a hassle? Any tips for cutting down on the anxiety?

A: Since children tend to thrive on predictability, a good rule of thumb for reducing anxiety related to pump site changes is to make this process as regular and predictable as possible. Unplanned site changes may be needed on occasion, of course. But for the most part, establishing a steady rhythm of changing sites at the same time, in the same place, and at whatever interval your child’s particular pump requires can help lessen anxiety, as it becomes just another normal part of her routine.

What time of day is best? You may want to discuss this with your healthcare provider. Also, think about an hour when you and your child may not be as stressed. For example, weekday mornings are often a very busy time, so you may not want to change sites first thing in the morning before school — unless you have to. Most parents and kids are already rushing to get out the door to work and school, and adding a pump site change into the mix often creates more anxiety. Late afternoons or early evenings may be more relaxed for everyone. It can also help to ask your child when he or she feels most relaxed during the day. Once you’ve negotiated a time, you may want to circle the dates on the calendar to visually reinforce predictability and also to make sure that you don’t forget.

Next, choose the place. Ask your child where he or she would feel most comfortable — perhaps the couch or some other peaceful spot in your home. On your end, when it’s the appointed site change day, have all supplies ready before you begin and do your best to complete the process as quickly as possible. To help your child stay calm, provide distraction. You could listen to music, play 20 Questions, or encourage your child to say the alphabet backwards or count backwards from a very high number. This may help calm your nerves, too! Keeping your own cool is a good way to model behavior for your child and can ease perceived discomfort.

As for site location, the best place to insert a site can depend on factors such as your child’s age and size or even the type of pump he or she is using. Always discuss issues like this with your child’s healthcare team, because they can give you more training and feedback to see if there is a new strategy that you may have overlooked.

–Deborah Butler, M.S.W., L.I.C.S.W., C.D.E., is associate director of pediatric programs at the Joslin Diabetes Center in Boston.

How Other Parents Deal

“When it’s time to change my daughter’s site, I aim for right after dinner. She’s not hungry, and we’re all feeling a little more relaxed. It also gives us enough time before bed to make sure the new site is working properly.”

–Joellen, Gainesville, Fla., mother of 3-year-old Sophia

Disclaimer: The information in these articles is not intended as medical advice. Families should check with their healthcare professionals regarding individual care.

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