How to Prepare Children for Surgery

by Columbia Surgery on November 16, 2012

No parent welcomes the idea of a child having surgery. But there are ways to lessen the toll of an operation on both you and your child. “The single most important thing parents can do is to become as knowledgeable as possible about their child’s condition or illness and the planned procedures beforehand,” says Angela Kadenhe-Chiweshe, MD, Surgeon, Morgan Stanley Children’s Hospital, NewYork-Presbyterian Hospital/Columbia University Medical Center. “Children from a very young age pick up on a parent’s anxiety or fear, so allaying your own stress by being fully informed will help your child enormously.”

Angela Kadenhe-Chiweshe, MD

Once you know what to expect, it will be easier to discuss your knowledge at your child’s level. It’s very important to match the amount of information you share with your child’s ability to absorb it.

Encourage your child to ask questions. It’s equally important to provide the kind of emotional reassurance only a parent can provide: letting your child know that he or she won’t be alone. Explain that you will be there the whole time, although you might not be able to come right into the operating room. Remind your child he or she still won’t be alone then, because the doctors, nurses, and other staff will be there to do the operation and be sure your child is safe and comfortable.

Depending on their age, children might start a journal about their surgery experience. If your child is too young to write, have him or her draw, paint, or color instead. You might also consider bringing to the hospital books, games, sketchpads, music player, or a laptop.

Here are more age-based suggestions on how to prepare your child for surgery.

Infants

For infants, it’s most important that parents communicate with each other. Comforting, familiar people and objects are also helpful, so be sure to pack your baby’s special stuffed animal, blanket, or pacifier. If you aren’t still nursing, bring the baby’s usual bottle for after the operation.

Toddlers

Talk with your toddler the day before the surgery, but not much further in advance. Try to clarify the reason for the surgery and that it has nothing to do with any imagined misbehavior on your child’s part. Give your child a choice of what toy or blanket to bring and what to wear to the hospital. Explain in simple terms what the nurses or doctors will do before they touch your toddler. Children at this age like to see their parents nearby, and they like to be held.

Preschoolers

Three- to six-year-olds need more time to absorb information, so speak with your child at least three or four days before surgery. Preschoolers may be anxious about being separated from their parents, so reassure your child that you will be available as much as possible. Remember that preschoolers learn through play, so if they want to play doctor or surgeon, encourage them.

Both toddlers and preschoolers are most afraid of separation, so many hospitals allow parents into the operating room until their child is anesthetized and bring them to the recovery room before they wake up.

Elementary School Age

This age child loves to ask questions, so all you have to do is encourage them. Begin discussing the surgery a week or two before admission, and be honest with your child about what to expect. Involve your child in the planning process as much as possible. School-age children may have fears of anesthesia, pain, or death. Help them verbalize such fears, which you can then address. Maybe your child could discuss the surgery with a doctor, or visit the hospital ahead of time. Remind him or her about what will happen afterward—stitches, bandages, pain medication, and so forth.

Finally, Dr. Kadenhe-Chiweshe says, “Keeping in mind the reason for the operation or the ‘destination’ so to speak, gives you confidence to endure the ‘journey’.”

{ 2 comments… read them below or add one }

Nathaniel Donson, MD December 28, 2012 at 5:51 pm

Great article! I was trained by Madeline Petrillo and Penny Bushman, the former, a nurse at New York Hospital, who wrote an excellent book with Sergai Sanger in the 60′s about helping hospitalized children,; and the latter, also a wonderful nurse, who started the first Child Life Program at Columbia’s Babies Hospital with psychiatrist Rodman Gilder. I carried on their work by starting a Child Life Program at St. Luke’s Hospital over the next ten years, working with children, their parents, pediatricians and the pediatric nursing and social work staff.

I would add to the article several ideas which came out of that work: the first of listening carefully for each child’s pre-operative narratives, often dramatically distorted (“Cardiac mermaid”), and responding to them with both sensitive understanding and corrective suggestions; the second of “preparation afterward,” that is following up the surgery or procedure by paying close attention to the child’s own variation of working through (or playing through) the procedure and helping his/her parents to respond appropriately. Although one should assume that these procedures are always traumatic, it is usually possible to offset subsequent post-traumatic symptoms if that is well done.

Nathaniel Donson MD

Columbia Surgery January 2, 2013 at 11:26 am

Thank you Dr. Donson for your comment. Your insight is a great addition to our article and much appreciated. Have a very Happy New Year.

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