When Your Toddler or Preschooler Needs a Test, Procedure, or Surgery

Your toddler or preschooler can grasp on some level what's going on if you keep explanations simple and short. Keep in mind that crying is a normal response in young children who are scared, anxious, or under stress. Your child hasn't yet developed coping skills and depends on you for them. Prepare ahead of time to help make the visit to the healthcare provider or hospital less frightening. The more your child knows beforehand, the less "new" it will seem. Studies have shown that children who are prepared have less anxiety about their treatment than children who aren't prepared.

Other tips to ease the way:

• Describe what the provider's office or hospital is like.

• Tell your child if they will have to stay overnight at the hospital. Reassure your child that you will be staying, too, if that is the case. You can often arrange to sleep over.

• Check that your child understands that the reason for the test, procedure, or surgery isn't because of anything they have done. Your child needs to know that they aren't to blame. Explain that the test or procedure is being done to help them feel better.

• Listen to your child. Young children use play to express their joys, fears, and all the feelings in between. Stuffed animals, dolls, and other toys are good aids. So are art supplies, since feelings can be expressed through drawing and painting. Your child can also tell stories.

Books can help your child understand what's going on. Many preschool books about going to the healthcare provider or the hospital are available at your local library or bookstore, or online. Here are a few examples:

• The Berenstain Bears Go to the Doctor by Stan and Jan Berenstain

• Going to the Doctor by T. Berry Brazelton

• Little Critter: My Trip to the Hospital by Mercer Mayer

• Going to the Hospital...What Will I See? by M.S. Jaynie R. Wood and Jo Berkus

• Franklin Goes to the Hospital by Paulette Bourgeois and Brenda Clark

• Curious George Goes to the Hospital by Margret and H.A. Rey

Before your child goes to the healthcare provider or hospital, you can:

• Role-play with your child. You can be the provider and your child can be the patient. Then switch roles. Older sisters or brothers can also get in the act with their younger sibling. Pets and stuffed animals can help, too.

• Have your preschooler help you pack meaningful toys, games, books, pictures, and other items that can comfort them while in the waiting room or hospital.

Once in the provider's office or hospital, encourage your child to do some of these things to relax:

• Breathe in a controlled manner

• Count backward

• Look through a kaleidoscope

• Play with a bubble blower or pinwheel

• Listen to music and stories

• Sing songs

• Tell stories

• Read pop-up books (toddlers) and find the hidden pictures (preschoolers)

• Watch DVDs or stream movies

• Play age-appropriate video games

Parents need to remember to stay calm and speak in a low, gentle voice. You have to be the role model for your child. Use your body language and your voice to show that you believe everything will be fine. And that you have complete trust in your child's healthcare provider and the rest of the healthcare team. Stay overnight if possible.

Other things you can do:

• Find out if you can be with your child during the procedure or surgery. Many hospitals let the parent go with the child into the operating room. But do this only if you can remain calm. Your presence could be reassuring, but not if you are visibly stressed.

• Reassure your child if they will need to be restrained during the test or procedure. (Restraints help keep your child safe and allow the test to be done correctly.)

• Have your child take part in decisions whenever practical.

• Provide family rules and routines as appropriate in the hospital.

You are the most important member of your child's healthcare team—because no one knows your child better than you! Let your child's healthcare provider know that you want to be a part of the treatment process.

Here are questions to ask before the test, procedure, or surgery:

• How long will the test, procedure, or surgery take?

• Will my child feel pain or discomfort?

• Will restraints be used? If so, what type?

• What are the risks involved?

• What outcomes have you seen with this medical condition?

• Who in addition to you is involved? Can I meet the healthcare team?

• What type of medical equipment will be used?

• What does this equipment look, sound, and feel like? Can I see the equipment?

• Does my child have to stop eating or drinking beforehand? If so, for how long?

• Will my child be awake for the procedure or surgery?

• What should I expect just before the procedure?

• What do you see as my role?

• Will I be allowed to be with my child during and after the procedure or surgery?

• How long will my child have to stay in the hospital?

• How many follow-up visits do you anticipate?

After the test, procedure, or surgery:

• Did my child have pain? If so, how long is it expected to last?

• How is this discomfort or pain being managed?

• What medicines are prescribed for my child? What are the side effects?

• If anesthesia was used, how long will it take to wear off?

• How should I expect my child to act now?

• What symptoms might mean there is a problem? For which ones should I call you right away?

• Do I have to restrict my child in any way or prevent them from doing any activities?

• How long can I anticipate until my child is "back to normal"?

Here are tips on how to tell your child what will happen:

• Tell them only the truth. Honest explanations about the test, procedure, or surgery are best.

• Break the information into small chunks. Too many details at once will overwhelm your child. About 15 minutes is all a young child can handle.

• Delay talking about the procedure or test until the day before it's scheduled. Youngsters at this age have a limited concept of time.

• Choose a quiet time to talk.

• Use a calm, reassuring voice.

• Use simple language and kind words. Use "warm" instead of "burning" to describe something they might feel during a test or procedure. When referring to anesthesia for surgery, explain "you will get to blow up a balloon."

• Try to focus on the sensory experiences, such as what your child will feel, hear, smell, and see.

• Focus on the positive. Let your child know the test, procedure, or surgery is being done so they can feel better.

Many hospitals have child life programs. A child life specialist is often part of the healthcare team. When working with you and your child, this specialist can help you:

• Understand the medical information presented to you so you have accurate descriptions of what will be done for your child

• To support your child, as well as help you and your family cope with and adjust to your child's illness

• Decrease your child's overall anxiety and perception of pain