Preparing Your Child for Surgery

When preparing your child for surgery, it is important to provide age appropriate information to alleviate misconceptions and minimize fears or possible feelings of guilt. It is also important to help your child understand the reasons for their necessary surgery and familiarize them with the surgery process.

Help your child learn what to expect. 

• Use simple words to prepare your child for surgery so they may understand the purpose for coming to the hospital.
• Be honest with your child to encourage a trusting relationship.
• Ask your child how they feel about their upcoming surgery to foster open communication. This will help address any possible fears or misconceptions regarding their surgery.
• Encourage your child to ask questions to you or their doctor to give them a sense of empowerment and control.
• Support your child with your presence, gentle voice, and touch to help reduce anxiety.
• Allow your child to choose a favorite stuffed animal, blanket, toy or comfort item to bring and keep with them throughout the procedure.

Age-specific guidelines to help your child cope with a surgery experience

Infants (birth to 1 year)

Appropriate concerns/behavior:

• Separation from parents and normal environment
• Parent’s anxiety often reflected to infant

Because infants are unable understand the reason for not eating or drinking before a sedated procedure, these are suggested ways you can help them cope with the wait:

• Swaddling
• Touching
• Massaging
• Rocking
• Holding
• Talking in low, calm, rhythmic voice
• Singing
• Bringing a comfort item or familiar toy

Toddlers (1 to 3 years)

Appropriate concerns/behavior:

• Separation from parents and normal environment
• Loss of control/autonomy
• Fear of the unknown
• Fear of abandonment or loss of love
• Difficulty understanding time; situation seems permanent

Suggested ways to cope:

• Tell your child about the surgery one to two days before the event
• Provide your child with basic and brief details about going to the hospital and what it is like
• Remind your child that surgery is not punishment for “being bad”
• Your child may become fussy with the change of environment and routine; it will help if you remain calm and patient with your child

Preschoolers (4 to 5 years)

Appropriate concerns/behavior:

• Because of their curiosity, magical thinking and not knowing what to expect, your child may imagine unrealistic/ negative experiences
• May feel surgery is punishment for something they did wrong
• May not understand the reason for the surgery

Suggested ways to cope:

• Tell your child about the surgery two to four days ahead of time
• Use simple words without too many details; include sensory information
• Assure the child the reason for the surgery is to get well, and not because the child did anything wrong

School-age children (6 to 12 years)

Appropriate concerns/behavior:

• Have fears associated with the loss of their body parts or body functions
• Anxiety about the illness/disorder and the effects of medical treatment
• Feelings of helplessness, loss of control, loss of respect, loss of love
• Anger about shots and other procedures that are out of their control; refusal to cooperate
• Fear of anesthesia or “sleep medicine;” often worry that they will wake up during surgery
• Modesty concerns
• Separation concerns linked to disruptions in routines of going to school, seeing friends and being at home

Suggested ways to cope:

• Prepare your child one to two weeks ahead of time
• Be open to answering the questions your child has, as best you can.
• Explain what will happen before, during and after the surgery; use minimally threatening sensory language
• Never use threats or bribes (If you don’t hold still, the doctor will give you a shot.)
• Praise your child for doing a good job; even if it was a seemingly a small task
• Encourage expression of fears and concerns
• Children may become angry or quiet in the hospital. This is normal. Be supportive and treat your child as normally as possible

Adolescents (13 years and older)

Appropriate concerns/behavior:

• Worry most about how the surgery will affect their appearance and how it will affect their daily routines and friends
• Fear of pain
• Reluctant to ask questions at the risk of sounding silly in front of others
• Concerned about privacy

Suggested ways to cope:

• Facilitate choices and control; include them in the plan of care
• Respect autonomy and respect privacy
• Give complete, honest explanations about surgery
• Provide opportunities for your child to discuss concerns with staff

Suggested children's books about surgery and going to a hospital

Franklin goes to the hospital. Jennings, Sharon. 2000. Lets patients know what to expect when going to the hospital.

Franklin va al hospital. Jennings, Sharon; Clark, Brenda, ill. 2002. Lets parents know what to expect when going to the hospital. Spanish Language.

Going to the Hospital... What will I see? and who are those people wearing funny clothes? Wood, Jaynie R.; Berkus, Jo; Selwyn, Joan, ill. 2009. Provides a valuable resource to caregivers who want to ease the transition into the hospital and help children with their experience from beginning to end.

Good-bye tonsils! Hatkoff, Juliana; Hatkoff, Craig; Mets, Marilyn, ill. 2001. A young girl describes what happens when she goes to the hospital to have her tonsils removed.

My brother needs an operation. Jaworski, Anna Marie; Ball, Linda, ill. 1998. Joey's little brother, Alex, has to go to the hospital for surgery and this is the story of how Joey handled it. The book includes room for the readers to write about their own similar experiences.

Paddington Bear goes to the hospital. Bond, Michael; Jankel, Karen; Alley, R. W. ill. 2001. Paddington had an accident and had to go to the hospital. See what he experiences.

Child Life

Child life specialists are trained in child development and work to ensure that children approaching challenging environments in the hospital are equipped with effective coping, understanding, and age appropriate education needed to maintain normal development and reduce anxiety. Texas Children’s Hospital‘s child life specialists are able to assist each child with their hospital experience relative to the child’s emotional and developmental needs. They are available to talk with your child about what to expect during their surgery experience.