Scared About Surgery? Here’s How to Ease the Fear

Be honest as you explain why your child's surgery is necessary—and what to expect before and after the procedure.

You might be surprised by the power a Popsicle can wield when it comes to reassuring kids who need surgery.

That’s a tip from Alexander Soutter, MD, a pediatric surgeon with Summerville Medical Center in Summerville, South Carolina. In his conversations with kids, he's straightforward, relaying details that paint an accurate picture of what they can expect before, during and after their operation. But he’s also quick to point out the bright spots: stickers at every appointment and post-surgery Popsicles in the recovery room.

Parents who are preparing their child for surgery should do the same, advises Dr. Soutter. “Take your cue from us. We want kids to think of surgery as an adventure,” he says. “It’s not a school day or a typical daycare experience. This is something new and different—and it involves Popsicles.”

Start by understanding the procedure

When it comes to preparing for surgery, the physical to-dos—pausing medications, for instance, or fasting before surgery as instructed by your doctor—are often straightforward. Easing your child's fears, allaying concerns and making it clear why the procedure is important, on the other hand, may be a bit more personal and complex.

Before you can reassure your child, however, you need to ease your own fears—something that may be easier said than done. The first step is to empower yourself with the facts.

Leading up to the procedure, meet with your child’s surgeon to discuss the condition, how the day will work, what the operation entails and the risks and benefits involved, Soutter recommends. As appropriate, let your child sit in on these conversations (more on that later). That way, kids see that this is just another grownup conversation and not cause for concern.

Remember, surgery cannot take place without your sign-off, notes Soutter. “You’re running the show,” he says. Take advantage of time with the doctor to ask all of your questions, which may help assuage any fears and concerns that you have.

Get your child involved

Once you’ve heard the surgeon’s explanations and responses to your questions, allow your child to have the same experience: a conversation with the surgeon about what to expect and why their surgery is necessary.  

“To the extent that your child can participate, they should—the kid should hear it all,” says Soutter. That means no hushed conversations, leaving the room or talking behind the child’s back. “I think it's important to tell parents and patients exactly what's going to happen.”

If you’re calm during this conversation, Soutter notes, your child will notice and likely mirror your behavior. “Kids see parents process the explanation and think, ‘Mom’s got this. I’ve got this!’” Soutter points out.

It’s important to understand that not all hospitals or surgeons have the same process. Your surgeon may not weave in enticing mentions of treats. The hospital may also not be as adept at using kid-friendly language. In that scenario, you may need to do more prep work and be ready to answer even more questions from your child, which may include:

  • Why is surgery necessary?
  • How long will the operation take?
  • Will I have to stay in the hospital overnight?
  • Why do I need anesthesia, and how does it work?
  • Will anything hurt?
  • What happens after the surgery? (Feel free to follow Soutter’s sugarcoated strategy here and suggest a treat—ice cream, for instance, or a stop at the toy store—on the way home from the procedure.)

Be honest but also age-appropriate

Kids and teens should hear all about their operation, including any risks involved—not just the possible benefits. Give them a rundown that covers what'll happen before, during and after the surgery. Remember to be honest, regardless of your child’s age, advises Soutter.

“It’s important for parents to tell the truth,” he says. Use reasonable limits, though, he notes. It’s fine to respond, “That won't happen,” if your child expresses concern about not waking up from anesthesia, Soutter explains.

The specifics—and how much depth you go into—will also vary based on your child’s age and level of curiosity.

It’s also wise to keep your child’s age and sensitivities in mind when choosing your words. Idiomatic language like “put you to sleep” or “knock you out” can be frightening to kids. Some children might associate the former phrase with a pet's death, while the latter may sound violent. Instead, use plain and simple words. Try, “The doctor will give you medicine that makes you sleep through the procedure. You’ll wake up, and the surgery will be over.”

When talking to young children, in particular, potentially scary words (think: cut, bleed, hurt) should be avoided in favor of more benign language (think: boo-boo, fix, better).

A word on timing: younger children usually need less time to process and cope with the procedure. A few days in advance is likely fine for toddlers and preschoolers, while a week or two is appropriate for school-aged children to start learning about their procedure and processing the information. Teens should be involved in all aspects of the decisions and planning for surgery.

Request a tour

Not all, but some, hospitals offer tours to families. Some facilities may even have professionals on hand who are skilled at demystifying surgery for kids, notes the American Society of Anesthesiologists. Inquire if a tour is an option for your child.

Encourage questions

Surgery for kids often differs from adult surgery in some important ways, notes Soutter. For example, kids often get a scent-coated mask with anesthesia before the IV and any needles—not after, as with adults.

For kids, asking questions may elicit comforting responses. Just like many adults, however, knowing what to expect is often better than fretting. As the German-based Institute for Quality and Efficiency in Health Care points out, “Children are generally very curious and want to learn about things, and surgery is no exception.” Avoiding difficult topics can have the unintended consequence of increasing, rather than diminishing, children’s fears about their wellbeing and surgery.

Ask about anesthesia

In some hospitals, parents can join their child as anesthesia is administered—the last moment a child will remember until the recovery room. “It does help with some kids, a lot,” Soutter says. “I think it’s very reasonable for parents to ask if they are allowed in the OR,” he adds. Check with the facility if this is an option for you.

Follow pre-op instructions

An empty belly is an anesthesia requirement, notes the American Academy of Pediatrics. Expect to receive detailed instructions on the timing for your child’s last pre-surgery meals and beverages. Follow these directions precisely. The last thing you want is a postponed or delayed surgery due to an early-morning bowl of cereal. If there aren’t specific pre-op instructions concerning any of the medications or dietary supplements that your child is currently taking, ask your doctor if you need to make any adjustments to these routines ahead of surgery. Don’t assume it’s safe for your child to take them in the days or hours before the procedure.

Aim to arrive at the hospital on time—or even early—to avoid delays. Make sure to bring your insurance card, any medications your child is taking (in their original bottles), a driver’s license or other identification for you and relevant X-rays or test results.

Do not make plans for later in the day and, if possible, arrange to have childcare for your other kiddos. This way you’ll be able to devote your full attention to your child who's having surgery.

Bring a lovey

Preparation helps, but the day of surgery may still be a bit unsettling and exhausting for children. Even kid-friendly hospitals aren’t the warmest or coziest of spaces. Bring along your child’s comfort items to make the space feel more like home.

“We do encourage kids to bring their stuffed animals or a quilt or favorite blanket,” says Soutter, who says these objects can have a positive, helpful effect. That’s common-sense advice backed by science: a 2014 study published in the Journal of Caring Science found that providing toys before surgery reduced children’s anxiety.

It’s a good idea to bring along some books or games for entertainment, too. There may be some waiting around, and these things may serve as welcome distractions.

Be strong and stay positive

Here’s the reality: Your child’s surgery is probably most nerve-wracking for you.

“In many cases, it is the parents who suffer the most just from anxiety,” Soutter says. Try to hide it if you can, he recommends.

The message to convey to children is that surgery, while out of the ordinary, is intended to help them—not hurt them. And when all is said and done, there just might be a Popsicle or other pleasant surprise waiting for them.

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