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

Preschool-aged children can benefit from preoperative planning, education, and explanations. Recognizing what is stressful to your preschooler while in the hospital can guide you in preparing him/her for the surgical experience. Common stressors and fears for preschool children may include the following:

  • Fear of being away from family and home, or being left alone
  • Thinking he/she is in the hospital because he/she is in trouble or being punished
  • Fear of having a body part damaged
  • Fear of needles and shots
  • Fear of waking up during surgery
  • Fear of pain (or the possibility of pain)
  • Fear of the dark
  • Fear of the unknown

How do I prepare my preschool child for surgery?

  • Preparation should take place several days before the surgery to give an adequate amount of time to prepare.
  • Touring the hospital before surgery can help your child see the sights, sounds, and events he/she will experience the day of surgery.
  • Contact a Child Life Specialist at (972) 566-4735 to arrange a preparation visit and hospital tour. A Child Life Specialist can also help explain what will happen, in terms your child can understand.
  • Make sure your child knows why he/she is going to have surgery. It is not uncommon for this age group to have misconceptions regarding surgery and/or hospitalization. Often, children think they have done something wrong or that surgery is done on kids who are “bad”.
  • Dramatic play is a big part of preschoolers’ life. Using pictures, stuffed animals, or toys to help your child understand is better than simply telling him/her what will happen. Illustrate the situation clearly for your child. Play “hospital” with your child at home before surgery. Role play through anticipated sequence of events to enhance their predictability. For example, putting on hospital gown, drinking medicine, riding on a bed, etc.
  • Give very simple, honest explanations and be careful of the words that you use. 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.” Avoid describing anesthesia as “putting you to sleep” because a preschooler may remember a family pet that was put to sleep and also wonder if they will also die. A better way to phrase it might be: “ A doctor will help you sleep (a different kind of sleep than how you sleep at night) during the operation, and he/she will wake you up after it is over.”
  • Read stories about children’s surgeries and hospital stays
  • Allow your child to help pack his/her own suitcase. Bringing a favorite security item, pictures of the 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 doctor fixes your arm, you can play basketball again.”
  • Learn as much as your 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 explain things to your child.
  • Make sure to stay with your child as much as possible- to provide comfort and security.
  • Be patient with your child. It is normal for him/her 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.
  • Give realistic choices such as “what toy do you want to bring to the hospital”, or “What arm do you want to wear your hospital bracelet?” Realistic choices give the preschooler a sense of control.
  • Remember to take care of yourself. Simplify your life during this time and do not be afraid to ask for help from family and friends. Remaining positive and non-stressed can help reduce your child’s anxiety.

Helpful books for you and your preschooler to read together:

  • "Barney and Baby Bop Go to the Doctor" by M. Larsen
  • "Franklin Goes to the Hospital" by S. Jennings
  • "Pooh Plays Doctor" by K.W. Zoehfeld
  • "Chris Gets Ear Tubes" by Betty Pace & Kathryn Hutton
  • "Good-Bye Tonsils" by Juliana Lee Hatkoff
  • "Tubes in My Ears: My Trip to the Hospital" by Virginia Dooley
  • "Koko's Big Ear Ache: Preparing Your Child for Ear Tube Surgery" by Virginia Dooley