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

Preschool-aged children can benefit from preoperative planning, education, and explanations. Begin preparing your child several days before the procedure. This will give your preschool child time to absorb it all. Recognizing what is stressful to your preschool child while in the hospital can guide you in preparing them for the experience. Common stressors and fears in the hospital may include the following:

• Fear of being away from family and home, or of being left alone

• Thoughts that they are in the hospital because they are in trouble or being punished

• Fear of having a part of the body damaged

• Fear of needles and shots

• Fear of waking up during surgery

• Fear of pain (or the possibility of pain)

• Fear of the dark

How do I prepare my preschool child for surgery?

• Most preschoolers have a fear of the unknown. Tell your child about the surgery several days before the procedure and perhaps even visit the hospital for a tour. Many hospitals will allow you and your child to visit before surgery. This can help your child see the sights, sounds, and events they will experience the day of surgery. It can help your child learn about the hospital, and it gives them time to talk about concerns and questions they may have. Contact the hospital's child life department for this service.

• Tell the truth in simple terms and answer all your child's questions. For example, "Yes, it will hurt, but it will not last long."

• Talk with your child about why they are going to have surgery. It's not uncommon for this age group to have misconceptions about a hospital stay. Often, 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. Using pictures, stuffed animals, or toys to help your child understand is better than simply telling them what will happen. Illustrate the situation clearly for your child. Ask a child life specialist to help explain what will happen and why in terms your child can understand. Also discuss therapeutic play activities, such as playing "hospital" with your child at home before they are admitted for the procedure.

• Give very simple explanations and be careful of the words that you use. For example, say, "The healthcare provider is going to fix your arm." Don't say, "The healthcare provider 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 they will die, too. A better way to phrase it might be: "A healthcare provider will help you sleep (a different kind of sleep than how you sleep at night) during the operation, and they will wake you up after it is over."

• Your child may enjoy reading books about the hospital with the family. Point out the parts of the story that your child may experience.

• Let your child help pack their own suitcase. Bringing a favorite security item, pictures of family and pets, and a special toy can be very comforting.

• Explain the benefits of the surgery in terms your child can understand. For example, "After the healthcare provider fixes your arm, you can play ___."

• Learn as much as you can about your child's surgery. Children can tell 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.

• Stay with your child as much as possible to provide comfort and security.

• Be patient with your child. It is normal for them to require more attention. Your child may have temper tantrums or be uncooperative. It is not unusual for your child to return to bedwetting or thumb-sucking. The regressive behavior will usually improve after the stress of the procedure has passed.

• Remember, too, to take care of yourself. Simplify your life during this time and don't be afraid to ask for help from family and friends. Remaining positive and nonstressed can help reduce your child's anxiety.

Helpful books for you and your child

Anne Civardi. 2005. Going to the Hospital(First Experiences). Usborne Publishing Ltd. (Ages 3 and up) 

Fred Rogers. 1997. Going to the Hospital. Penguin Young Readers Group. (Ages 2 to 6)

Deborah Hautzig. 1985. A Visit to the Sesame Street Hospital. Random House for Young Readers. (Ages 4 and up)

Richard Scarry. 1995. A Big Operation (The Busy World of Richard Scarry) . Aladdin Paperback. (Ages 2 to 4)

Debbie Duncan. 1995. When Molly Was in the Hospital: A Book for Brothers and Sisters of Hospitalized Children . Rayve Productions, Incorporated. (Ages 3 and up)

Paulette Bourgeois. 2011. Franklin Goes to the Hospital. Kids Can Press. (Ages 3 to 8)

Virginia Dooley. 1996. Tubes in My Ears: My Trip to the Hospital . Mondo Publishing. (Ages 4 to 7)

Juliana Lee Hatkoff, Craig Hatkoff. 2004. Good-Bye Tonsils! Puffin Books. (Ages 4 to 8)

Norman Bridwell. 2000. Clifford Visits the Hospital. Scholastic Incorporated. (Ages 4 to 8)

Margret Rey, H.A. Ray. 2010. Curious George Goes to the Hospital. Houghton Mifflin Harcourt. (Ages 4 to 7)

Barbara Taylor Cork. 2002. Katie Goes to the Hospital. Brighter Child. (Ages 5 to 8)

Joanna Cole. 1990. The Magic School Bus: Inside the Human Body. Scholastic, Incorporated. (Ages 4 to 8)