It's been said that "minor" surgery is surgery on someone other than yourself. One exception to this adage is when your child needs surgery.

All children can benefit from psychological preparation for planned surgical experiences. Adequate preparation can help children feel less anxious about the surgical process and have a smoother recovery.

Studies show significant differences in post-surgery anxiety between those children prepared for surgery and those who were not. The differences are consistent across age groups, gender, and pain levels of surgery.

Preparing Yourself

To prepare your child for surgery, you must prepare yourself as a parent. Become as knowledgeable as possible about the planned surgery. At the preoperative office visit, ask your child's surgeon about the length of the surgical procedure, expected time in the operating room, pain control, wound care, and recovery time.

Most surgeries are now "same-day" procedures requiring no overnight or prolonged stays. At least one parent may stay with the child at all times except while the surgeon is operating. After surgery, you may stay with your child in the recovery room. If hospitalization is required, Children's Hospital at Erlanger allows parents to stay overnight, minimizing separation anxiety for both parents and children. Before surgery, help your toddler by reading books about going to the hospital. Use clear, simple explanations about procedures.

As a parent, you can help your child by remaining calm. Simplify your life during this time. Don't be afraid to ask for help from family and friends. Children, including infants, will sense if you're frightened or stressed. Nonverbal communication, such as relaxed facial expressions, gestures, and body language, can give positive assurance to your child before surgery.

Preparing Your Child

Once you're prepared for your child's upcoming surgery, you're ready to prepare your child. How you prepare your child will depend on his age, maturity, and level of development. Children cope much better knowing what will happen and why it is necessary. Give information at your child's level of understanding, correcting misconceptions and dispelling fears and feelings of guilt.

Infants

Although infants are too young to understand verbal explanations, they can benefit from your efforts to minimize stress in the hospital environment. Stressful situations for infants may include separation from parents, strange sights, sounds, and smells, changes in routines or sleep patterns, and different caregivers.

Before the day of surgery, maintain your baby's routine. Inform the nursing staff of your baby's schedule, including sleep patterns and feeding habits. Plan to distract, rock, walk, and comfort your baby during the brief period before surgery when eating and drinking are not allowed.

Bring your baby's favorite security item to the hospital to create a familiar environment. Give lots of love, and let your baby know that you will be nearby.

Toddlers

Common hospital fears for toddlers may include:

• Being left alone
• Staying in a strange bed or room
• Losing the comforts of home, family, and possessions
• Being in contact with unfamiliar people
• Painful procedures
• Medical equipment that looks and sounds scary
• Feeling helpless

Before surgery, help your toddler by reading books about going to the hospital. Interactively play with dolls or stuffed animals. Use clear, simple explanations about procedures.

Preschoolers and Young Children

Interactive play and books also help preschoolers and school-age children. Touring the hospital before surgery allows children to see and hear events they will experience on surgery day.

Ensure preschoolers and young children know why they will have surgery and clear up any misconceptions. Often, children think they have done something wrong or believe needles are given to kids who are "bad."

Teens

Common fears and concerns of teens who are facing surgery include:

• Loss of control
• Being away from school and friends
• Having a body part damaged or changed in appearance
• Fear of surgery and its risks
• Pain
• Dying during surgery
• Fear of what others will think about their sickness or hospitalization.

Books and Internet articles can help your teen learn more about his upcoming surgery. Let your teen know it is acceptable to be afraid and cry. Recording thoughts and feelings in a journal may be helpful to your teen. Encourage friends and family to call, visit, or send cards after surgery so your child will be assured of a robust support system.

Additional Support

Pre-surgery Tours with Our Child Life Specialists

Children aged four and older may benefit from a pre-surgery tour offered by our Child Life Specialists. These staff members are highly trained to attend to hospitalized children and their families' emotional, social, and developmental needs. On the tour, they help patients and their families become more familiar with the staff, equipment, and environment before the day of surgery. Tours are designed to answer any questions children may have about the procedure and increase parents’ ability to be supportive throughout the entire surgical and recovery process.

• For more information and to register for a tour, please call (423) 778-2154 at least two business days before surgery.
• Learn more about our Child Life Specialists

Download our Family Guide to Preparing Your Child for Surgery

Written by Lisa A. Smith, MD, FACS