Preparing your child for medical procedures

Faced with multiple unfamiliar people, equipment and situations children often need reassurance. Informing children about what to expect before, during and after their anaesthetic can address fears and misunderstandings, and decrease stress and anxiety. All children are different, so how you prepare your child will vary depending on their age and development.

It's also normal for parents and carers to feel nervous or worried as well. Preparing yourself as to what to expect, is just as important as preparing your child.

The role of Child Life Therapy

Child Life Therapy recognises the stress and anxiety that hospitalisation can cause children and their families. Child Life Therapists at Sydney Children's Hospital Randwick work as part of the health care team in the Short Stay Surgical Unit (C1 South West), providing positive play experiences, procedural education and distraction.  

Child Life Therapists can assist you in developing a plan to support your child. You know your child best, so the more information you can give us about your child, the more tailored the plan can be. We can provide you with a variety of resources prior to the date of your child's procedure and organise a pre-admission visit if necessary. 

Like more information?

Call Child Life Therapy on (02) 9382 0007

Pre-admission visits

Would you like to visit the hospital before your child's procedure? A visit to the hospital gives your child a chance to become familiar with the environment and ease anxiety about the unknown. Pre-admission visits provide an opportunity for discussion, questions and can uncover misunderstandings your child may have.

A pre-admission visit with a Child Life Therapist helps prepare your child for what they will need to do, and where they will go on the day of their procedure. Child Life Therapy can help prepare your child for specific experiences during their stay, such as breathing through a mask, getting an IV, having a blood test, or how dressings and plasters will look and feel. A pre-admission visit is also an opportunity for a positive play experience in hospital. Each pre-admission visit can be tailored to best meet the needs of your child. Bookings are essential.

Alternatively, you are welcome to visit the hospital in your own time. Getting to know the main areas, orientating yourself to the location of the Short Stay Surgical Unit, as well as finding the fun spaces within the hospital (eg. Starlight Room, Fairy Garden and Playground) can provide a positive introduction to the hospital environment.

Like more information?

Call Child Life Therapy on (02) 9382 6984 

Babies

General anaesthetics can be frightening and stressful for babies. Knowing what may stress your baby will help you know how to best support and comfort them.

Possible concerns

• Separation from parents
• Strange sights, smells and textures
• Unfamiliar people
• Change in routine (eg. interrupted or altered sleep routine)
• Change in temperatures

How can you help prepare your child?

Although it may feel like there isn't much you can do to prepare your baby, there are a number of things you can do.

• Maintain your routine: Leading up to the day of your baby's general anaesthetic, try to stick to your babies usual routine so that they (and you) are well-rested.

• Bring comfort items: Bring your baby's favourite comfort items and toys to hospital such as a blanket, dummy, or soft toy. These familiar items will help your baby feel safe, in an environment that is new and strange.

• Be present: Give your baby lots of cuddles. Your voice and touch will reassure and comfort your child.

• Tell staff about your routine: If you are staying overnight, tell the nursing staff about your usual feeding and sleeping times. Feel free to bring in any music on your phone/iPod to make the environment more home-like.

• Look after yourself: It is normal to feel stressed and worried about your child. Try to get as much rest as possible leading up to the day. Waiting times prior to general anaesthetics vary, so make sure you eat before you arrive. It's a good idea to have a support person you can contact if need be. Babies can sense your stress and anxiety, so doing things to help you stay calm will help your baby too. If you have other children, ask a family member or friend to look after them on the day of your child's general anaesthetic. 

Like more information?

Call Child Life Therapy on (02) 9382 6984

Toddlers

Possible concerns

• Separation from parents or carers
• Unfamiliar people and environment
• Unfamiliar and possibly frightening medical equipment (eg. mask, blood pressure cuff)
• Change in routine
• Possible belief that coming to hospital is a form of punishment

How can you help prepare your child?

• Be present and reassuring: Your voice and presence will comfort your child. Reassure them that you will be with them as much as possible and that they haven’t done anything wrong. Bring activities to do together while waiting or in recovery (eg. toys, colouring in, books, iPad) to help create positive experiences during your stay.

• Don’t prepare your child too early: Time is a foreign concept for toddlers. It is recommended that you tell your child about their hospital visit 1-2 days in advance.

• Offer choice where possible: Give your child a sense of control and allow them to pick a special toy or blanket to bring with them.

• Play: Try to be playful throughout your visit. Play can help your child cope with the waiting time, and feel at ease in an unfamiliar environment. We have lots of toys and activities at the hospital, but it can be good to bring some of their favourite toys from home.

• Be as calm and patient as possible: Everything in hospital will be unfamiliar and out of routine. Your child will be required to fast and wait, and in these circumstances it is normal if your child “acts out”. Remaining calm will help your child.

Like more information?

Call Child Life Therapy on (02) 9382 6984

Pre-schoolers

Possible concerns

• Separation from parents or carers
• Pain or harm to their body
• Misconceptions from a lack of understanding
• Difficulty imagining what will happen, and may fear something worse
• Possible beliefs that coming to hospital is a form of punishment

How can you help prepare your child?

• Be present and reassuring: Your voice and presence will be a comfort to your child. Reassure your child that you will be there as much as possible and that they haven’t done anything wrong. You may like to bring things from home that you can do together while waiting or in recovery (eg, books, colouring-in, cars, comforters) to help create positive experiences during your stay.

• Prepare your child: We recommend you tell your child about their hospital visit 2-5 days in advance, depending on the individual needs of your child.

• Consider the words you use: Children at this age may have 'magical thinking'. Choose your words carefully, avoiding words with double meanings. For example, telling your child they will be “put to sleep” may remind them of their pet being euthanised at the vet. An alternative would be to say: “the doctors are going to help you have a special hospital sleep”.

• Reinforce that your hospital visit and procedure is not punishment: Reassure your child that everyone in the hospital is there to look after them and that they didn’t cause the need for surgery. Tell them that it is ok to be scared and encourage them to express their thoughts and feelings.

• Offer choice where possible: Give your child a sense of control and allow them to pick a special toy or activity to bring with them.

• Use play: Play can help build resilience and provide a positive experience for your child while in hospital. Children learn best through play, so it can also be used to prepare your child. Using a medical kit at home, and read books about coming into hospital can help your child feel more prepared, and address fears or misunderstandings they may have. 

Like more information?

Call Child Life Therapy on (02) 9382 6984

School-aged children

Possible concerns

• Loss of bodily control
• Loss of independence
• Fear that their body will be harmed and the procedure will change their physical looks
• Fear of pain
• Fear they will wake up during their procedure

How can you help prepare your child?

• Allow time for preparation (be specific as needed): We recommend you prepare your child 1-2 weeks in advance depending on the individual needs of your child. It is good to talk about what to expect before, during and after their procedure. When preparing your child, it can be good to think the five 'W's'; Who? (eg. are you going to meet), What? (eg. will happen), Where? (eg. on the body), When? (eg. will you be visiting the hospital), Why? (eg. do you have to visit the hospital).  Children in kindergarten, Years 1 and 2 will need different information to a child in Year 6, so it's important to think about how much detail you provide.

• Read appropriate books: Read books about visiting hospital (see attached PDF for examples) as another way to help prepare your child.

• Be supportive and honest: It's normal for your child to become nervous prior to their surgery and they may act out, becoming angry or upset. Reassure your child that you will be there as much as possible, and encourage them to talk about their feelings. Be honest with your child about their hospital visit as this will assist them in building trust with staff.

• Check for understanding (correct misconceptions): School-aged children may not understand everything that is said the first time. Get your child to explain back to you what you just said and repeat things as required. It is important to choose your words carefully and avoid any words that may have double meanings. For example, telling your child they will be “put to sleep” may remind them of their pet being euthanised at the vet. An alternative would be to say: “the doctors are going to help you have a special hospital sleep”.

• Offer choice where possible: Offer choices to your child when appropriate to help them feel empowered. For example, offer medication in a syringe or medicine cup. Be sure to speak to staff before offering choices to avoid confusion.

• Involve friends: Encourage your child’s friends to keep in touch, particularly if your child is required to stay in hospital. They may like to write letters, FaceTime or visit.  

Like more information?

Call Child Life Therapy on (02) 9382 6984

Teenagers

Possible concerns

• Loss of independence and control
• Fear of how the procedure may change their looks and body
• Restriction of physical activities or school attendance
• Impact on activities with friends
• Peer acceptance
• Enforced dependence
• Fear of possible embarrassment
• Fear they will not wake up from the general anaesthetic

How can you help prepare your child?

• Involve your teenager in decisions and care: Give your teenager as much control as possible and make them a partner in the direction of their care. It's important to discuss their concerns openly and honestly, and provide preparation as appropriate.

• Be truthful: Lying, tricking or withholding information from your teenager will affect their trust and they may become upset or angry. It is important to consider both how and what you say.

• Respect and maintain privacy: Help maintain your teenager's privacy at all times. Request blankets or sheets for modesty in procedures if necessary, and for private locations to change. Children at this age can be conscious of their bodies and the way they look.

• Address potential recovery periods and follow-up required?: Discuss follow-up appointments, what's involved in recovery and how long it might take. Talk about when they can return to sport or their favourite activities.

• Encourage questions and discussion of concerns: Encourage your teenager to ask questions about their hospital visit. If you are unable to answer their questions, write them down and then ask the most appropriate person from the hospital.

• Maintain connection with friends: Encourage your teenagers' friends to visit, and keep in contact via phone, text or FaceTime.

Like more information?

Call Child Life Therapy on (02) 9382 6984

Children with additional needs

Child Life Therapy at the Sydney Children’s Hospital, Randwick can help plan your admission and provide preparation resources and support.  On the Short Stay Surgical Unit (C1 South West) a Child Life Therapist can assist you in developing a plan to best support your child. You know your child best, and the more information you can tell us about the individual needs of your child- the more tailored the visit can be. Child Life Therapy can provide you with a variety of resources prior to the date of your child's procedure, and can organise a pre-admission visit should that be appropriate. To speak to a Child Life Therapist, please call (02) 9382 6984.

 Things to consider;

• Preparation

Every child is different, as will be the preparation required. For more preparation tips, refer to the other sections of this webpage. Alternatively, you can speak to a Child Life Therapist who can assist you with advice and resources for preparing your child based on their individual needs and past hospital experiences.  

• Pre-admission visits

You may like to organise a pre-admission visit to the hospital prior to the day of your child's procedure. Visiting the hospital on a day when there aren't any procedures or appointments booked can help ease anxiety and manage expectations. Alternatively, you can speak to a Child Life Therapist who can provide you with appropriate pictures of the space, along with other preparation resources.

• Triggers

Inform staff of your child's triggers that may cause distress (eg- noise, light, crowded space). This can help staff create an environment to best support you and your child.

• Comforters and toys

Remember to pack your child's comforters from home. These can help in situations that are new and possibly overwhelming (eg- pillow case, dummies, iPad, music). While we have a range of toys at the hospital, it may be beneficial to bring a toy from home that your child loves and can play with throughout their stay.

• Communication

Bring any special communication resources or devices with you. Inform staff to help them make your child feel more at ease.

• Extended waiting times

Waiting times can vary- and be extended for a variety of reasons. Bring your child's favourite things to do to help ease worry and stress which can grow while waiting.

• Play

Try to be playful throughout your visit. Play will help your child feel at ease while waiting- so it can be good to bring some of their favourite toys from home. It may also be comforting for your child to have something familiar while in an unfamiliar environment.

Like more information?

Call Child Life Therapy on (02) 9382 6984

Siblings

Siblings of children having procedures under general anaesthetic may also benefit from preparation. Siblings may see and hear things they don’t understand and worry about their brother or sister.

Possible feelings

• Confusion: Siblings may not understand why or what is happening, especially if your visit to hospital is unexpected. Preparing them will help them to understand what is happening.

•  Worry: Siblings often worry about their brother or sister, as well as their parent when they are away from home. Keep them informed as much as possible.

• Guilt: Siblings may worry that they have caused the hospitalisation due to a fight, or being angry with their brother or sister. Siblings may also feel guilty that they aren’t sick instead. Reassure your child.

• Loneliness: Siblings may miss having their brother or sister around to play or hang out with. They can also miss having their parents at home. Having a photo or special item with each of them may help.

• Jealousy and rejection: Siblings can feel left out or not as important. They might be jealous of the attention given to their brother or sister, and of the visitors and gifts they receive. Young siblings may not understand and can think that everyone is having fun in hospital. Siblings may have to miss out on their usual activities which can contribute to feelings of rejection. Helping them to understand the situation, keeping to routine as much as possible and having a familiar person such as a family member or friend can help.

• Anger: Siblings may sometimes feel angry their brother or sister is sick. They may also feel angry that their parents did not prevent the need for your hospital visit, or angry at themselves that they have little power to change the situation. Help them to understand their feelings and reassure where possible.

Possible behaviours

• Change in behaviour: Your child may act out, and become more angry, frustrated or upset than usual.
• Change in eating habits: Your child may refuse to eat, or change their usual eating behaviour.
• Change in sleeping habits: Your child may have difficulty sleeping or may want to sleep for longer periods.
• Saying they feel sick: Your child may report that they also feel sick, and seek increased attention from you.
• Regress to previous behaviours: thumb sucking, bed wetting or tantrums are examples.
• Change in play: Your child may play aggressively with toys.

How you can support your siblings

• Prepare them: Explain the situation to your children and discuss the change to routines. Encourage them to ask questions, share their thoughts, feelings and worries. Some children might think something far worse is happening if information is withheld from them. Young children need simple explanations, and older children may need more detail.
• Provide reassurance: If your child is young, reassure them that you aren't going away forever and you will still see each other. Explain to your other children about changes to normal routine and who will be looking after them.
• Maintain connections: Provide opportunity for siblings to visit, or speak to their sibling on the phone or with FaceTime. Siblings might like to make a card or picture for their brother or sister, and your child in hospital may like to make one in return.
• Keep in contact: If your other children have to stay with a family member or friend while you are in hospital, maintain contact with them. Arrange appropriate times for siblings to visit and prepare them for this. When you do spend time with siblings, offer them lots of extra love. Give them lots of hugs, praise and compliments.
• Have special time together: If possible, try and schedule some special time with your other children. Whether it be reading a book with just the two of you, or going on an outing, this helps them feel special and included.
• Consider Routines: Try to keep the same meal times, sleep routines and schedule. If your other children are staying with family or friends, inform them of their normal routine so it can be followed as much as possible.
• Read book s: Read books about visiting hospital. Books can help prepare your child as to what to expect when visiting their brother or sister.
• Tell their teacher: Letting your child’s teacher and other caregivers know what's going on can help them be aware of any changes in behaviour and provide reassurance.

Like more information?

Call Child Life Therapy on (02) 9382 6984

General tips

• Play: Children learn through play. It helps them make sense of the world, express their thoughts, feelings and worries, and normalise the environment. Bring your child’s favourite toys to the hospital; it will help them feel at ease. Be playful where possible; medical play using toy doctor kits, dolls and soft toys can familiarise your child with medical equipment and alert you to any fears or misunderstandings your child may have. Remember to consider your child's age and development when using play as preparation, using words and terms they will understand. 

• Be honest: It is normal to want to protect our loved ones from things that may worry or stress them. However, it's important to be truthful with your child. Tell them why they are coming to hospital, using easy to understand, age-appropriate language, and answer questions honestly. Being dishonest can lead to mistrust, which can affect forthcoming appointments and future health and hospital-related appointments as well. If you are unsure of what to tell your child, or how to answer some of their questions, Child Life Therapy is here to help. 

• Chat together: Encourage your child to ask questions and express worries they may have. Talk to your child about that five W's; Who? (Who are you going to meet), What? (What will happen), Where? (Where on the body), When? (When will you be visiting the hospital), Why? (Why do you have to visit the hospital). If your child has questions you are unable to answer, write them down and ask the most appropriate health professional. Your child may not have a lot of questions one day, but many have a lot on another. Be sure to provide more than one opportunity for questions and discussion to help your child know that they can always voice their concerns.

• Watch your words: Tailor your explanations to your child's age and individual level, and use words they understand. Consider possible double meanings—for example; telling your child they will be “put to sleep” may remind them of their pet being put to sleep at the vet. An alternative would be to say “the doctors are going to help you have a special hospital sleep”. It can also be good to find alternatives for words that will have no meaning such as "tourniquet", "anaesthetic" or "EMLA". Alternatives such as "seat belt for your arm", "sleeping air", and "numbing cream" could be used. If you're unsure of what words to use, speak to Child Life Therapy. 

• Read books together: Books about coming to hospital can help prepare your child using language they will understand. Stories can often provide opportunities for children to ask questions, express fears or worries, as well as a time for you to pick up on any misunderstandings. See our suggested book list below.

• Offer choice: Choice can be empowering to children especially when their normal choices are removed due to hospitalisation. Involve them in packing and selecting toys or activities to bring. In hospital, offering choices to your child when appropriate can provide a sense of control. Children are sometimes able to pick which arm their name band goes on, or if they drink their medicine out of a syringe or medicine cup. Please check with staff before offering them to your child to avoid confusion.

• Be present and patient: Regardless of your child's age, provide as much reassurance as possible. Give your child lots of hugs, hold their hand, and be present as much as you're able to. Acting out, or misbehaving is normal when feeling lots of different emotions such as fear, worry or when being faced with the unknown. Remind your child that you are there to support them, give them lots of love, and try and be as patient as possible. Tell your child it's normal to feel frightened or nervous, and help them channel these feelings properly. Be at the hospital whenever possible, and organise others to visit should you be unable to stay all the time.

• Give encouragement and praise efforts: Provide lots of encouragement to your child during their stay, and acknowledge the things they have done well. Verbal compliment, stickers or small rewards may be useful 

• You are your child's best advocate: You know your child best. Inform staff about any individual needs or past experiences that you feel may impact your child's coping so that a supportive plan can be discussed.

• Look after yourself: Remember to look after yourself and enlist help from family or friends where possible. Although your child may be fasting, make sure you eat prior to coming in so that you have energy for the day ahead. Ask family and friends for help, and be sure to speak to staff should you have any concerns. While your child is having their general anaesthetic, you may like to visit the Ronald McDonald Family Resources Room on Level 2, where you can relax and have a cup pf tea. You can also access the Prayer Room which is located in the adjoining Royal Hospital for Women on Level 0.

Still concerned?

Talk to a Child Life Therapist on (02) 9382 6984

Suggested book list

Reading age-appropriate books about going to hospital is a great way to prepare your child and start conversations about the hospital visit. Books provide your child opportunities to ask questions and explore any worries or misunderstandings they may have.

There are lots of storybook options. Visit your local library or children’s book shop to see what's available. Here's a few of our suggestions.

• “Peppa Goes to Hospital” By Lady Bird
• "Going to the Hospital” By Anne Civardi
• “Going to the Hospital- Sticker Book” By Anne Civardi
• “Topsy and Tim go to Hospital” By Jeam and Gareth Adamson
• “My First visit to the Hospital” Bu Eve Marleau and Michael Garton
• “Maisy Goes to the Hospital” By Lucy Cousins
• “Frankin Goes to the Hospital” By Jennings Sharon

When a child goes to hospital, they can feel disconnected from family, siblings, or friends; the books listed below can help children talk about their feelings.

• “My Many Coloured Days” By Dr Seuss
• “In My Heart. A book of feelings” By Jo Witek
• “The Invisible String” By Patrice Karst

Download the list.

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