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Having Surgery at Children's

Tips for Preparing your Child for a Procedure

Eating and drinking before surgery
It is very important to carefully follow the eating and drinking guidelines to prevent your child’s operation from being delayed or canceled. To decrease the risk of complications associated with vomiting, your child’s stomach must be empty before surgery.

At midnight the evening before surgery, do not give your child solid food, including:
  • Formula (breast-feeding can continue longer; see instructions below)
  • Juice with pulp (such as orange juice)
  • Milk or milk products
  • Hot or cold cereal
  • Pudding
  • Chewing gum
  • Candy or mints
If your child is breast-fed, you may continue to breast-feed until four hours before the scheduled surgery time.

Your child may have clear liquids until 4 hours before the surgery time. Clear liquids include apple juice, water, JELL-O, popsicles, sports drinks (like Gatorade), and pedialyte.

To recap, here are the guidelines about eating and drinking before surgery:
  • No solids, milk, or formula after midnight.
  • No chewing gum or candy (including breath mints) after midnight, as these are considered solid food.
  • No brushing teeth the morning of surgery.
  • No clear liquids (sugar water, apple juice, etc.) within 4 hours prior to surgery.
  • No breast milk within four hours prior to surgery.
  • Prescribed tablets, capsules, or liquid medications should be taken with a sip of water at usual time, but before leaving home. If your child has difficulty taking oral medicine this way, please discuss this with the pre-op nurse at the time of the pre-operative call.
Special note:
While we would never advise their use, on the day of surgery do not smoke, drink alcohol, or use recreational drugs. These can cause your surgery to be unsafe and cancelled.



Talking to Your Child
Children’s National Medical Center understands that you may be unsure about what to tell your child about surgery. Below are some age-appropriate guidelines from our Child Life specialists to help prepare both you and your child:



Infants (0 to 12 months old)
Be prepared. If you are prepared, you will be more relaxed around your child. Familiar objects and people are important to infants. Bring a favorite blanket, toy, or pacifier to the hospital. After surgery, infants are more likely to drink from a familiar bottle nipple or sippy cup, so it can be helpful to bring an empty bottle or cup for use after surgery. Also remember, it is important to try to keep routines as normal as possible.

Toddlers (1 to 3 years old)
Begin preparing your toddler a day before surgery. Use simple words a small child would understand. Read books about going to the hospital.  Engage your child in play with a toy medical kit to help with expression of feelings. Toddlers are learning to be independent and like to make choices. Offer only realistic choices: Which stuffed animal would you like to take with you? Which T-shirt would you like to wear to the hospital?

During exams at the hospital, explain what the doctors or nurses will do, before they touch your child. Toddlers learn by watching, so you may let the nurse listen to your heart first. This helps make the surgery exam as non-threatening as possible.


IF THESE GUIDELINES ARE NOT FOLLOWED, YOUR CHILD’S SURGERY WILL BE DELAYED OR CANCELLED. WE APPRECIATE
YOUR ATTENTION TO THESE IMPORTANT GUIDELINES.

Preschoolers (3 to 5 years old)
Prepare your preschooler three days in advance. Talk to your child about the hospital. Explain that the hospital is a safe place, where many kids come to see doctors. Be honest, giving simple explanations and answers to your child’s questions without too many details. Help your child understand that he or she did not do anything to cause the surgery, procedure, or hospitalization. Be careful not to force a discussion about the upcoming event if your child does not seem ready. Here are some suggestions for language to use with your child:

  • Stretcher: “Bed with wheels”
  • Blood pressure cuff: “Arm hug”
  • Anesthesia: “Sleepy air”
  • Induction room: “Sleepy air room”
  • Recovery room: “Wake up room”

Play is how preschoolers learn, so playing hospital or doctor is very beneficial. You can use a toy doctor kit and stuffed animal to play measuring temperature and blood pressure, listening to your body (stethoscope) and drinking medication. This will help your child become more familiar with medical equipment and provide an excellent opportunity to express his or her feelings about the upcoming medical event.

Elementary School-Age Children (5 to 12 years old)
Prepare your child about 1 to 2 weeks ahead of the visit. Help your child understand why he or she needs to have the procedure, surgery, or hospitalization. Allow your child the opportunity to ask questions and express concerns. Give your school-age child more detail about what he or she will hear, see, smell, and feel while in the hospital. Be very honest. The true facts may be less frightening than your child’s exaggerated imagination of what might happen. Ask your child open-ended questions such as, “What are you wondering about your operation?” Fear of body mutilation is common at this age, so let your child know if a body part will look different after surgery. Prepare your child for seeing stitches or bandages.

Teens (12 to 18 years old)
Adolescents are learning independence and decision-making. They are concerned with body image, loss of control, privacy, and relationships with friends. Talk about what is going to happen and give as much detail as the adolescent may need. Encourage adolescent participation in discussions with the doctor or nurse. Take the time to help your adolescent write down questions they may have. Remember, all questions are important. Be honest. Respect your adolescent’s need for privacy.


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What to Tell Siblings
Remember that other children in the family may have questions, too. Use simple, honest language that they can understand to talk about the coming surgery. Let your children know that all of their feelings are ok and it is important to talk about them. As much as possible, allow siblings to be involved in their brother or sister’s care. Siblings feel included when they are assigned tasks that are helpful to the family. Try to keep family routines as normal as possible.

Additional Support
Children’s Child Life specialists are available for consultations and visits. Contact the Child Life Services program at (202) 476-3070.
There is also a presurgical tour for kids.


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