Preparing a Preschooler for Surgery

What part about surgery is most stressful for a preschool child?

Understanding what might be stressful to your preschool child while he or she is in the hospital can help you prepare for the surgical experience. Children are often worried about:

• Being away from family and home, or of being left alone.
• Having a part of the body damaged
• Needles and shots
• Waking up during surgery
• Pain
• Being in the dark

How do I prepare my preschool child for surgery?

Preschool-aged children can certainly benefit from preoperative planning, education, and explanations provided several days before the procedure:

• Preschoolers fear the unknown. Your child should be told about surgery several days in advance and visit the hospital for a tour. Learning about the hospital provides time to talk about concerns and ask questions. Contact the hospital's child life department for this service.
• Tell the truth in simple terms and answer all of your child's questions. For example, "Yes, it will hurt, but it will not last long."
• Make sure your child understands the reason for surgery. Often, preschool children think they have done something wrong or that needles are given to kids who are "bad."
• Dramatic play is a big part of a preschooler's life. Use pictures, stuffed animals, or toys to help your child understand is better than simply telling him/her what will happen. Ask a child life specialist to help explain what will happen, and why, in terms your child can understand. Also try therapeutic play activities such as playing "hospital" with your child at home before he/she is admitted for the procedure.
• Give very simple explanations and use words carefully. For example, say, "The doctor is going to fix your arm." Do not say, "The doctor is going to make a cut on your arm." If you describe anesthesia as "being put to sleep," your preschooler may think of a family pet that died and wonder if he or she will die, too. A better way to phrase it: "A doctor will help you sleep (a different kind of sleep than how you sleep at night) during the operation, and wake you up after it is over."
• Your child may enjoy reading books about the hospital with the family.
• Allow your child to help pack his or her own suitcase. Be sure to pack a favorite toy and pictures of family and pets.
• Explain the benefits of the surgery in terms your child can understand. For example, "After the doctor fixes your arm, you can play ___ ."
• Learn as much as you can about your child's surgery. Children know when their parents are worried. The more you know, the better you will feel and the more you can help explain things to your child.
• Be with your child as often as possible to provide comfort and security.
• Be patient with your child. It is normal for him or her to require more attention, have tantrums or be uncooperative. It is not unusual for your child to return to bedwetting or thumb sucking. Regressive behavior should improve after the stress of the procedure has passed.
• Take care of yourself. Simplify your life; ask for help if you need it. Being positive can help reduce your child's anxiety.

At the Family Surgery Program at Atlantic Health System Children's Health, physician services are provided by Atlantic Medical Group and are on staff at Goryeb Children's Hospital.