Surgery is a delicate topic, especially when younger children are involved. With that in mind, I decided to research ways parents can normalize the discussion for themselves and their child through the various stages of development.
What I found is there are many stressors regarding surgery to be discussed and equally as many options for parents to ease their child’s stress levels. Following is a breakdown, provided by Children’s Hospital at Dartmouth-Hitchcock (CHaD) in New Hampshire, that offers age-appropriate information about surgery.
Common causes of stress for infants 0-12 months:
- Separation from parents
- Unfamiliar caregivers
- Strange sights, sounds, and smells
- New and different routines
- Interrupted sleep
How you can help your infant:
- Make sure you and your baby are well rested.
- Attempt to remain calm; your baby can pick up on your stress.
- During the period when your baby cannot eat, attempt to distract him by rocking, walking and comforting him
- Bring a favorite blanket or pacifier to the hospital. It may also be helpful to have a familiar bottle for use after surgery or procedures.
Common causes of stress for Toddlers: 1-3 years
- Being left alone
- Loss of comforts
- Stranger anxiety: contact with unfamiliar people
- Medical equipment
- Restricted movement
How you can help your toddler:
- Plan to begin preparing your toddler a day before his procedure. Preparation too far in advance can cause more anxiety.
- Toddlers like to make choices, so offer some when- ever possible. For example, have your toddler choose which toy to bring or which shirt to wear.
- Explain who the staff at the hospital are and what they will do before it happens.
- Provide simple explanations and be careful of your wording. For example, say “The doctor is going to fix your [penis]. Do not say “The doctor is going to make a cut on your [penis].”
- Read books to your child about going to the hospital.
Book recommendations from the Children’s Hospital at Dartmouth-Hitchcock (CHaD) to read to your child:
For toddlers, these are ChaD’s book recommendations:
- Going to the Hospital by Anne Civardi.
- A Visit to the Sesame Street Hospital by Deborah Hautzig.
- The Berenstain Bears: Hospital Friends by Mike Berenstain.
- Curious George Goes to the Hospital by Margret Rey, H.A. Rey.
- Big Operation: The Busy World of Richard Scarry by Richard Scarry.
Common causes of stress for preschoolers:
- Begin preparing your preschooler a few days before his procedure. Preparation too far in advance can also cause more anxiety with this age group.
- Being left alone
- Fear of having a body part damaged
- Fear of needles and shots
- Fear of pain or the anticipation of pain
- Interrupted routines
How you can help your preschooler:
- Explain what the hospital will be like in honest and simple terms, and answer all questions. For example, if asked about pain, explain to your child: “Yes it will hurt, but not for long.”
- Explain to your child why he is having the scheduled procedure. Preschoolers often feel they have done something wrong and surgery is their punishment for being bad.
- Choices can increase your child’s sense of control, so offer them when appropriate and possible, such as favorite things he wants to bring to the hospital.
- Tour the facility with your child prior to the procedure. Dartmouth-Hitchcock Medical Center (DHMC) offers a Sneak-a-Peek tour for surgery. Other children’s hospitals and medical centers may do the same, so ask the doctor or hospital you’re going to if that is an option.
- Read books to your child about going to the hospital.
For preschoolers, these are ChaD’s book recommendations:
- Franklin Goes to the Hospital (Volume 25) by Paulette Bourgeois and Brenda Clark (Illustrator).
- When Molly Was In The Hospital: A Book for Brothers and Sisters of Hospitalized Children by Debbie Duncan and Nina Ollikainen (Illustrator).
- A Visit to the Sesame Street Hospital by Deborah Hautzig.
- Curious George Goes to the Hospital by Margret Rey and H.A. Rey.
- Do I Have to Go to the Hospital? Going to the Hospital (A First Look At…Series) by Pat Thomas.
- Going to the Hospital by Anne Civardi.
Common causes of stress for School-aged children: 5-12 years
- Plan to begin preparing your child a week before his procedure. Preparation too far in advance can cause more anxiety for these children.
- Loss of control
- Fear of pain or the anticipation of pain
- Fear of needles and shots
- Fear of waking up during surgery
How you can help your school-aged child:
- Make sure your child knows why he is having surgery. School-aged children may feel they’ve done something wrong and surgery is their punishment for being bad.
- Explain the benefits of your child’s surgery. For example, “When your [penis] has healed, you will be able to [pee okay].”
- Choices can increase your child’s sense of control, so offer them when appropriate and when possible.
- Ask your child to say back to you what is going to happen at the hospital. This can help you learn whether or not your child has a clear understanding of what to expect.
- Tour the facility with your child prior to his surgery.
- Let your child know it’s okay to be afraid and to cry.
- Because school-aged children have very active imaginations, be sure to talk to them honestly.
- Encourage your child to ask questions and provide honest answers to limit misunderstanding.
- Read books with your child about going to the hospital.
For school-aged children, these are ChaD’s book recommendations::
- Franklin Goes to the Hospital (Volume 25) by Paulette Bourgeois and Brenda Clark (Illustrator).
- Going to the Hospital by Anne Civardi.
- When Molly Was In The Hospital: A Book for Brothers and Sisters of Hospitalized Children by Debbie Duncan and Nina Ollikainen (Illustrator).
- A Visit to the Sesame Street Hospital by Deborah Hautzig.
- The Hospital Book. Morrow by James Howe and Mal Warshaw.
- Curious George Goes to the Hospital by Margret Rey and H.A. Rey.
- Do I Have to Go to the Hospital?: Going to the Hospital (A First Look At…Series) by Pat Thomas.
Common causes of stress for teenage children: 12-18 years
- Teens like to be active participants when it comes to decision making. So attempt to act as partners when making decisions together. Parent and teen can begin learning and preparing as soon as the decision to have a procedure has been made.
- Loss of control
- Change in appearance
- Fear of surgery and its risks
- Fear of pain
- Fear of dying during surgery
- Fear of the unknown
- Concern with body image
How you can help your teenager:
- Teenagers are often uncomfortable admitting they do not understand. Parents and healthcare professionals may need to explain the procedure and treatment several different ways to help a teen fully understand and become more comfortable.
- Teenagers also need comfort items from home so parents should encourage them to bring books, tablet, phone, games, music, soft blankets, slippers, or a favorite pillow.
- Parents should be truthful in answering any and all questions. Teenagers are quick to pick up on a parent’s skirting of the truth and can become angry if they feel they are being lied to.
- Parents and teen should tour the facility prior to surgery.
- Teenagers should read about going to the hospital or having surgery.
Source for the information in this article: Children’s Hospital Dartmouth-Hitchcock (CHaD)
The hospital your child’s procedure will take place in may have additional supportive information and resources on their websites as well.