Comfort Positions: How to Help Children Feel Safe and Supported During Medical Procedures

Monday March 3, 2025

Medical procedures can be stressful for children, often leading to fear, resistance, and lasting anxiety. Comfort Positions offer a simple and powerful way to ease distress, ensuring a safer, more supportive experience for children, caregivers, and medical teams. WE C Hope CEO, Abby White, and Child Life Specialist, Morgan Livingstone, explore how comfort positioning transforms medical care, fostering trust, cooperation, and emotional well-being.

A bald toddler sits on her mother’s lap during a port access procedure. Her back rests against her mother’s chest, and her head is turned up and back towards her mother, who is leaning down in conversation. Both mother and child are white. The nurse accessing the port is seen from behind and has fair hair.

A mother holds her daughter in a back-to-chest comfort position, wrapping her right arm around her daughter to gently secure and support her arms. The child can choose to look at the nurse or up towards her mother who calmly coaches her through the port access procedure.

Supporting Children Through Stressful Medical Care

Imagine this: your young child, frightened and tearful, faces a nurse ready to administer eye drops or insert an IV. As a parent, your instinct is to comfort and protect, but you’re unsure how to help. The hospital environment feels intimidating, perhaps overwhelming, and your child’s anxiety grows as the procedure begins.

This is a common scenario for families navigating retinoblastoma care. From diagnostic tests to routine procedures, medical interventions can be emotionally and physically challenging for children and caregivers.

Using comfort positions can transform these experiences, creating a safer and more supportive environment for the patient, parent, and professional. Below, we explore what comfort positions are and how they work, their benefits for everyone involved, how you can use them to support your child or patients, and how to advocate for them in Rb care.

The Impact of No Comfort Hold Support

When a child doesn’t have the support of comfort positioning, the procedure experience can become distressing for everyone involved.

For the Child

Without comfort positioning, the child may feel exposed, fearful, and helpless. Fear can magnify their sense of pain and distress, and hinder their ability to cooperate and cope to the best of their ability, making the process more difficult. So their experience of the procedure may be worse than expected.

Over time, repeated negative experiences can lead to procedural anxiety – fear of a negative medical experience before the visit has even happened. The child may intensify or regress to outgrown behaviours like crying, tantrums, or attempting to escape from the procedure. Or they may shut down entirely and “submit” to the procedure – often misinterpreted as being a good, cooperative child.

Procedural fears can complicate future medical care, which is especially important for survivors with long term follow up care needs and second cancer risks.

For the Parent or Caregiver

Watching a beloved child struggle through a procedure, unable to give comfort and ease their distress, is heartbreaking. The experience can haunt parents long after the procedure, causing deep grief, frustration, and guilt.

Over time, the lack of opportunity for parent involvement can strain the child’s trust and sense of security in the parent-child bond, making the medical journey even more stressful.

For Medical Professionals

When a distressed child resists medical care, the procedure becomes less safe and typically takes longer to complete. More staff may be called in to restrain the child. Increasing stress for the medical team, and the procedure may need to be delayed or rescheduled to accommodate additional staff or sedative medication.

Comfort positions provide a better way – helping children feel secure, empowering caregivers, and supporting healthcare professionals to run calmer, more efficient procedures.

What Are Comfort Positions?

Comfort positions are secure, calming holds that allow caregivers to support their child emotionally and physically during medical procedures. Unlike traditional restraint methods, comfort positions focus on helping the child feel safe and supported while ensuring the medical team has the access they need.

These positions vary depending on the child’s age, stage of development, temperament, and the procedure. For example:

A toddler might sit on a caregiver’s lap with their legs wrapped around the adult’s waist during an injection.
An older child may lean against a caregiver or hold their hand for support during a blood draw.

Comfort positions involve cooperation between the caregiver and medical staff to ensure the child’s physical and emotional needs are met throughout the procedure.

To use comfort positions effectively for the child, it’s important to understand what they are – and also what they are not.

Comfort positions are not restraint.

Holding a child down against their will to force compliance is the opposite of comforting or soothing. Doing so can rapidly destroy trust, harm the caregiver-child relationship, increase long-term medical anxiety, and cause lasting trauma.

Comfort positions are not a substitute for consent.

Clear, age-appropriate communication about the procedure, and consent to be held and begin/continue/stop the procedure should always be used with comfort holds.

Comfort positions are not a “one-size-fits-all” solution.

Each child and procedure is unique – comfort positions must be adapted to the situation, the child, their caregiver, and the procedure.

By respecting these principles, caregivers and medical teams can use comfort positions with compassion to effectively support the child.

The Benefits of Comfort Positioning

Comfort positions offer numerous advantages for children, caregivers, and medical professionals:

For Children

Helps them feel safe and secure, reducing fear and distress.
Lowers pain perception, increasing their cooperation during procedures.
Builds trust in medical environments, reducing hospital-related anxiety.

For Caregivers

Strengthens the bond with their child by giving them an active supporting role.
Increases confidence in their ability to help during medical procedures.
Improves satisfaction with the overall medical experience.

For Medical Teams

Streamlines procedures by reducing the child’s resistance.
Requires fewer staff members to complete a procedure.
Creates a calmer, safer, more efficient environment for care.

A mother holds their very young infant in a secure chest-to-chest comfort position during a medical procedure, gently supporting the baby’s head with one hand. The hands of a medical professional are visible, placing a stethoscope on the baby’s back. The baby’s expression shows some discomfort and distress, but their hands, relatively loose against the parent’s chest, suggest the comfort hold is soothing.

Comfort holds are valuable for newborns, teens, and all ages in between.

The Evolution of Comfort Positions

The concept of comfort positioning was pioneered in the 1980s by child life specialists Mary Barkey and Barbara Stephens. They saw that traditional restraint methods often caused children unnecessary trauma.

Through research and practice, they developed the Comfort Measures Model, which prioritised emotional well-being while maintaining procedural efficiency. Today, comfort positions are endorsed by the World Health Organization, the American Academy of Pediatrics, and many others worldwide.

Child life specialists continue to advocate for the use of comfort positions as a gold standard in paediatric healthcare, working with families, medical teams, and policy makers to improve children’s medical experiences.

When to Use Comfort Positions

Comfort positions can be used for a wide range of procedures, including:

Giving eye drops or other medication.
Eye exam, vision test, eye ultrasound.
Blood draw, IV insertion, injection (including vaccination)
Central line or port access.
Lumbar puncture.
Routine examination such as checking vital signs.

Almost any medical procedure can benefit from a comfort position. They are particularly useful for young children who may feel scared or overwhelmed in a clinical setting.

Choosing the Right Comfort Position

Selecting an appropriate comfort position depends on three key factors:

The Procedure: The position must allow medical staff constant easy access to the required area of the body.
The Child’s Age and Developmental Stage: Younger children may need full-body support, while older children might only need a hand to hold.
The Child’s Temperament: The best position takes into account how the child typically responds to medical care, adjusting the level of physical contact and support as needed. g. a child who typically kicks during procedures will benefit from a comfort position that gently restricts the movement of their legs.

How to Use Comfort Positions

Using comfort positions effectively involves preparation, collaboration, and practice.

Communicate with the Medical Team

Before the procedure, explain your desire to use a comfort position. Discuss what the medical team needs during the procedure, and how you can work together to make this happen. Agree a plan that meets everyone’s needs.

For example, a medical team may have access to a lightweight sheet that will help wrap and cuddle your child safely so they feel secure during a procedure; the light wrap helps them keep their body safely still while the procedure takes place. Infants all the way up to older children may benefit from this comfortable swaddle.

Parents, you may need to advocate firmly to ensure your child’s right to a comfort position is met – you can do this!

Practice at Home

Familiarize yourself and your child with the chosen position to build confidence and reduce surprises on the day of the procedure. This is important for you as much as for your child.

Practice repeatedly. Practice is how children learn and assimilate new information and experiences. Like learning how to play piano, kick a soccer ball or master a new language, children need to practice daily to really feel confident and comfortable mastering a new skill. This is the same with comfort positioning.

Safety is paramount, and your confidence to hold your child securely will grow with practice. If you are nervous, it can be helpful to begin your practice with a large doll or stuffed animal so you are familiar with the hold before introducing it to your child.

Stay Calm and Positive

Your calm reassuring presence will help your child feel more at ease. Identify some healthy coping tools you can use before and during the procedure to calm your body and mind so you can focus on supporting your child. These resources can help.

If you need additional support, ask for a child life specialist to be present with you.

Ensure Safety

Hold your child securely to prevent sudden movements, especially during procedures involving needles or other sharp instruments. If the medical professional has any concerns about your hold, they will pause the procedure to ensure everyone’s safety. This is why practicing at home is so valuable.

Close up of a quote in white child-like font on a blue shirt. Text reads: When little people are overwhelmed by big emotions, it is our job to share our calm, not to join in on their chaos. L.R. Knost. The background is Below is a purple heart composed of two overlapping band aids.

A gentle reminder on Morgan’s t-shirt.

Collaborating with Medical Teams

More and more healthcare professionals are embracing the benefits of comfort positions, but most are still unfamiliar or hesitant to use them. As chief advocate, you can work with the medical team to bridge this gap and ensure your child has effective procedure support.

Educate: share information about the research-supported benefits of comfort positioning, and highlight its value as a patient-centred care practice.
Demonstrate: Offer to model the comfort position to the medical team to show them how it works, or practice it with your child in their presence.
Collaborate: Approach the conversation as a partnership, showing that you respect the team’s expertise, while asserting your child’s needs.
Persist: Change takes time. Keep advocating for comfort positions until they become a routine part of care.

Example Comfort Positions

Some children need to see each step of the medical procedure, while others prefer to look away. Comfort positions can accommodate both approaches and work well alongside distraction activities.

Below are four primary comfort positions that can be used to support children through many different procedures. The second set of five positions can be particularly helpful for young children receiving eye drops.

Back to Chest

A man holds a child-sized puppet on his lap during a medical procedure.

The child sits with his back to the parent’s chest. The parent can secure one arm with a hug, while the other arm is free. The child’s legs can also be secured by holding them at the ankles between the parent’s legs.

Allows the child to feel more in control.
Allows the child to participate in a distraction activity
Lets the child choose to see what is happening or look away.

Chest to Chest

A man hugs a child-sized puppet, talking calmly while supporting its head to face away from the medical procedure taking place.

The child sits chest to chest with the parent, his legs off to each side. His legs can only kick from the knee down and one arm is secure. The parent can give the child a warm, nurturing hug throughout the procedure.

Allows the child to participate in a distraction activity
Lets the child choose to see what is happening or look away.

Legs to the Side

The child sits on the parent’s lap with his legs off to one side. The parent holds the child’s hand throughout the procedure. The child’s legs can be secured by shifting him to the parent’s back leg, securing both legs between the parent’s legs.

Allows the child to feel more in control.
Allows the child to participate in a distraction activity
Lets the child choose to see what is happening or look away.
Works best for a child who needs only a little help staying still

On The Bed

A man sits on a chair, supporting a child-sized puppet who sits on a bed during a medical procedure.

The child sits on the bed or examination table with the parent positioned behind him, providing comfort and stability.

Allows the child to feel more in control.
Allows the child to participate in a distraction activity
Lets the child choose to see what is happening or look away.
Works best for a child who needs only a little help staying still

More Comfort Positions for Giving Eye Drops

Cradled – Baby

A woman applies pretend drops to a demonstration infant doll laying in her lap and cradled in her arm. Her left arm is wrapped comfortingly around the baby and she holds both arms in place across the chest while applying the drops with her right hand.

The baby is held securely in place by the parent’s comforting arm, while the free hand is used to apply the drops.

Cradled – Older Child

A woman applies pretend drops to a child-sized medical play puppet laying in her lap, cradled in her arm. The child is secured by the woman’s left arm, wrapped comfortingly around the shoulders. Her hand rests over the child’s arms, which lie on the chest, crossed at the wrists. She applies the drops with her right hand.

The child’s hands are crossed on the chest and can be restrained by the parent’s comforting arm, if needed.

Baby on Lap

A woman applies pretend drops to a demonstration infant doll laying in her lap, head resting on her knees, legs leaning on her torso.

Applying drops can be difficult in a young baby who is facing away from you. The baby is more secure on your lap in this position, and you can also easily do infant massage to calm your baby before applying eye drops. If you worry your baby may kick, you can place a cushion between yourself and your baby’s feet.

Stroller 1

A woman applies pretend drops to a child-sized medical play puppet sitting in a stroller. The child’s hands are relaxed down by the side. The head is fully supported by the stroller, and the woman has both hands free to apply the drops, if needed.

This position is good for children who are more confident with eye drops. The child needs no restraint and is fully supported by the stroller. The parent has both hands free to apply the eye drops, if needed. Never approach a child from behind without warning or preparation to apply eye drops.

Stroller 2

A woman applies pretend drops to a child-sized medical play puppet sitting in a stroller. The child’s arms are crossed over the chest and gently restrained by the woman’s left hand. She reaches over the child’s shoulder from behind to place her left hand flat on the child’s arms, while applying the drops with her right hand.

This adaptation of the Stroller 1 position supports children who need a little reassurance to master their confidence with eye-drops. Both hands can be gently but firmly restrained on the child’s chest. Never approach a child from behind without warning or preparation to apply eye drops.

This fabulous video from our friends at Children’s Hospital Colorado shows the first three main positions in action, along with super tips for supporting children of different ages, including babies.

Empowering Children and Families to Thrive

Comfort positions have the power to transform a child’s medical experience, turning moments of fear into opportunities for trust and resilience. For caregivers, they provide a meaningful way to support their child in challenging times. For medical teams, they create a calmer, safer, more collaborative, and efficient environment in which to deliver care.

By incorporating comfort positions into routine practice, we can create a new standard of compassionate, child-centred healthcare. Together, we can ensure every child feels safe, supported, and empowered throughout their medical journey.

Child Life On Call, in collaboration with The Meg Foundation for Pain, offers a handy Comfort Positions Guide, with separate versions for caregivers and clinicians.

Get Your Comfort Positions Guide from Child Life On Call

About the Authors

Abby’s father was diagnosed with bilateral retinoblastoma in Kenya in 1946. Abby was also born with cancer in both eyes. She has an artificial eye and limited vision in her left eye that is now failing due to late effects of radiotherapy in infancy.

Abby studied geography at university, with emphasis on development in sub-Saharan Africa. She co-founded WE C Hope with Brenda Gallie, responding to the needs of one child and the desire to help many in developing countries. After receiving many requests for help from American families and adult survivors, she co-founded the US chapter to bring hope and encourage action across the country.

Abby enjoys listening to audio books, creative writing, open water swimming and long country walks.

Abby is wearing a blue and white patterned top, dark pink collared cardigan, and light blue patterned skirt, and a heart necklace. She is pictured with her black German shepherd - golden retriever guide dog, who is wearing a pink collar with guide dor tag showing. Both are smiling broadly. The background is a bed of bright orange marigolds, a low hedge and tall trees.

Read the story of how WE C Hope began.

Morgan and Doc McStuffins Morgan Livingstone is a Certified Child Life Specialist and Certified Infant Massage Instructor/Trainer. She is passionate about improved child life and psychosocial supports for children and families affected by retinoblastoma.

As the Child Life Officer of World Eye Cancer Hope, Morgan contributes to the website’s Child Life sections, and speaks globally about child life supports for children with retinoblastoma.

Since 2017, Morgan provided enriched multi-day child life programming for children of all ages at the Canadian Retinoblastoma Research Advisory Board meetings and the One Retinoblastoma World conference.

Morgan also writes and creates resources for children and adults, and participates in child life research studies. She won the inaugural Innovation Grant at Operation Smile for developing an APP that uses Virtual Reality to prepare children receiving cleft lip and palate surgery for their operation.

Download Morgan’s helpful parent manual for supporting children’s worries using Worry Eaters.

Follow Morgan on Twitter