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What can I do to prepare my toddler for surgery?

QUESTION: My 22 month old daughter needs to stay overnight in the hospital for a minor operation. What can I do to help her prepare and not be frightened?

ANSWER: Surgical operation requires separation from your child. This separation can bring up fear for child and parent alike! Reassuring your child that you remain connected through the experience (even when he is asleep under anesthesia!) is the first step to calming a child's fears.

The following guidelines can help you ease your child through this process:

1. Explain what will happen and why

Even if you are talking to a one year old, your explanatory tone will help a child understand that what is being done is a good thing. You and the doctor are on the same side, helping her! Use language appropriate to your child's level of understanding. For example: "When we go to the hospital, the doctor will give you some "sleepy juice" so you can rest while he gently puts tubes in your ears to help them stay clear. I will be there when you fall asleep and when you wake up. " Address your child's questions as they arise naturally. Do not overwhelm her with information, but do answer her questions truthfully, in a manner appropriate to her age.

2. Visit the hospital beforehand if possible.

Introduce the hospital environment to your child in a friendly manner. This will reduce disorientation and fear when the day for surgery arrives. Bring a favorite toy from home as a symbol for bridging the comfort of home with the hospital setting.

3. Use art to express fears and hopes

Draw pictures of "before" and "after" when possible. Children express their fears through drawing, which can release tension. Talk to them about their fears, and guide them to making a "healthy" picture of the positive outcome they want to achieve!

4. Be prepared to discuss and enact the experience through play and talking with your child afterwards

Children (and adults!) integrate major experiences by telling stories about them. Talk about how you went to the hospital together to get the doctor's help, and how things will be getting better. Allow room for negative as well as positive feelings to be expressed. Be aware that it is common for your child to integrate the experience through play. Supply appropriate dolls and toys that provide the opportunity for her to re-enact the experience, but do not force the issue. Allow her to spontaneously work it through in her play. Some children may do this by playing "doctor" and performing successful "surgeries" on dolls for some period of time, after the operation!

Avenues for expression will help your child integrate the experience, and achieve a sense of mastery, rather than feeling overwhelmed.

Use the opportunity of preparing for surgery to deepen your bond with your child. After all, sharing difficult life experiences is what growth is all about!

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Gayle Peterson, MSSW, LCSW, PhD is a family therapist specializing in prenatal and family development. She trains professionals in her prenatal counseling model and is the author of An Easier Childbirth, Birthing Normally and her latest book, Making Healthy Families. Her articles on family relationships appear in professional journals and she is an oft-quoted expert in popular magazines such as Woman's Day, Mothering and Parenting. . She also serves on the advisory board for Fit Pregnancy Magazine.

Dr. Gayle Peterson has written family columns for ParentsPlace.com, igrandparents.com, the Bay Area's Parents Press newspaper and the Sierra Foothill's Family Post. She has also hosted a live radio show, "Ask Dr. Gayle" on www.ivillage.com, answering questions on family relationships and parenting. Dr. Peterson has appeared on numerous radio and television interviews including Canadian broadcast as a family and communications expert in the twelve part documentary "Baby's Best Chance". She is former clinical director of the Holistic Health Program at John F. Kennedy University in Northern California and adjunct faculty at the California Institute for Integral Studies in San Francisco. A national public speaker on women's issues and family development, Gayle Peterson practices psychotherapy in Oakland, California and Nevada City, California. She also offers an online certification training program in Prenatal Counseling and Birth Hypnosis. Gayle and is a wife, mother of two adult children and a proud grandmother of three lively boys and one sparkling granddaughter.

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