Pediatric Prep

Infants 6-12 months

What to expect: Your child may be fussier than normal due to feeling hungry and not having anything to eat or drink. Your nurse or doctor will let you know when your infant can eat again after the procedure. Please bring formula or milk with you.

How to help:

• Use sensory stimulation to soothe.
• Provide a pacifier.
• Bring a favorite blanket or stuffed animal.
• Talk in a calming voice.
• Hold or rock your child.

Toddlers: (1–3 years)

What to expect: Your child may become irritable and uncooperative due to feeling hungry and not having anything to eat or drink. While children may strongly assert their independence at this age, they still fear separation from their caretakers.

How to help:

• Talk to your child about the procedure one or two days prior.
• Use simple words to explain what will happen (“The doctor is going to fix ____ body part.”).
• Let your child make some choices. Choices could include what items to bring from home, which arm to use when getting a blood pressure and what to eat after the procedure, when possible.
• Bring a favorite item from home (blanket, stuffed animal or toy).
• Keep food and drink out of sight. Toys and activities can distract toddlers as long as they don’t see any food or drink.
• Be patient. It’s common for toddlers to be fussy or clingy during a hospital visit. Giving comfort and support can be very helpful.

Preschoolers (3-5 years)

What to expect: In addition to being hungry, your child may become anxious, jumpy or confused. It’s common for children in this age group to have fears and misconceptions about a hospital experience. They may think they did something wrong to cause the hospital visit.

How to help:

• Talk to your child about the procedure two or three days prior to give him or her enough time to process the information.
• Use simple words that your child knows to explain what body part the doctor will fix.
• Encourage your child to ask questions and express feelings. Open-ended questions such as, “Tell me about the procedure you are going to have,” are a great way to discover and clarify any misconceptions.
• Keep food and drink out of sight. Toys and activities can often distract preschoolers as long as they don’t see any food or drink.
• Allow your child to bring a favorite item from home (blanket, stuffed animal or toy).
• Be patient. It’s not uncommon for preschoolers to regress during a hospital visit. Temporary behaviors like wetting the bed or sucking their thumb may arise.

School-Age and Adolescent Children (5-12 years)

What to expect: In addition to being hungry your child may express fear, anxiety and concern of bodily harm. While your child may have a better understanding of what is happening, he or she may still experience fears and misconceptions of bodily harm.

How to help:

• Talk to your child about the procedure one or two weeks prior.
• Use language your child understands while being honest and realistic.
• Schedule a pre-op tour for you and your child. The more prepared you and your child feel, the less anxiety you’ll both have on the day of the procedure.
• Ask open-ended questions to address fears and concerns (“How do you feel about going to the hospital?”) and give chances for your child to express feelings.
• Allow your child to pack a bag for the day with comfort items like a stuffed animal, blanket, music or games.
• Focus on the positive, like how much better your child will feel after the procedure.

Teens (13-18 years)

What to expect: It’s common for teens to feel a loss of control over their surgery. While your teen understands what is happening, he or she may have concerns about body appearance or going under anesthesia.

How to help:

• Involve your teen in all aspects of planning the surgery.
• Encourage your teen to be an active participant in his/her health care by asking the doctor or nurse questions.
• Talk to your teen about the surgery to clarify any misconceptions and allow him/her to express fears.
• Focus on the positive, such as how much better your teen will feel after the surgery.

Common Concerns:

Anesthesia: Explain that the anesthesiologist is a doctor who will make sure your child doesn’t feel anything during the procedure and will wake your child up when the procedure is done.

IVs: If your child is 8 years or older, a nurse may need to place a pre-op IV per doctors orders. While this is the standard, we can discuss special exceptions.

Pain: Encourage your child to choose coping techniques used in the past. It may help to develop a plan to use when your child feels pain (deep breathing, squeezing an object or hand, using imagination to “go” somewhere else, listening to music, and using TV or video game as distractions).

Additional Resources

We recommend talking and doing small preparation activities such as coloring pages and some role-play to prepare your child. The more prepared your child is the less anxiety you both will have on the day of the procedure.

While we are not affiliated with Johns Hopkins, their Pediatric Surgery coloring book that is downloadable has great pages for pre-op activities for your child. Relevant pages are 4-9, 12, and 14-19.

https://www.hopkinsmedicine.org/johns-hopkins-childrens-center/patients-and-families/_documents/JHCC-Surgery-Coloring-Book-8.22.14.pdf

We reside on the Anne Arundel Medical Center Campus, and they have a great Pediatric Virtual Tour video that you and your child can watch. While we are not owned by them, and the locations are different the general information about the steps while you are preparing for, during and after surgery are universal.

https://youtu.be/_3IYeLYxNeA