If your child is scheduled for surgery, there are several important steps that can help ensure a safe and successful procedure. Easing pre-surgery jitters is a big part of it. But making sure your child is physically prepared in the weeks, days, and hours before an operation is just as important.
Instructions before surgery vary among patients. They can depend on factors like age, medical history, and the specific operation. It’s important to closely follow these directions to avoid complications or surgical delays, says Mark McCollum, MD, a pediatric surgeon in Eatontown, New Jersey.
Still, there are general guidelines most anyone needs to follow to be physically ready for surgery.
Weeks or days before surgery
Be medication savvy
Make a list of all your child's prescription and over-the-counter (OTC) medications or supplements. Note dosages and how often your child takes these drugs or products. Your healthcare provider (HCP) will tell you what your child should continue taking. They will also let you know what medications they should not have before surgery and when to stop taking them.
Anything that could interfere with blood clotting should be avoided before an operation. This includes many OTC medications, such as ibuprofen and herbal supplements. Exactly when your child should stop taking them will depend on the specific medication or supplement involved.
It’s also important to let the medical team know if your child has an allergy to any medications or food. Let them know about anything that could cause skin irritation, as well, such as latex.
Monitor your child’s health
Call your HCP if your child develops any signs of illness within a week of the scheduled surgery, Dr. McCollum advises. These include a rash, runny nose, a sore throat, fever, or irritability. Your child may need treatment before the procedure, or it may be delayed until your child has recovered.
Boost nutrition
Surgery stresses the body, so it's wise to go into an operation as strong as possible. Eating a well-balanced diet can help support a healthy immune system and promote wound healing, which may shorten recovery time. Focus on foods like fruits, vegetables, whole grains, and lean proteins, such as chicken and fish.
Meet the anesthesia team
This is often done on surgery day. But, if your child is having a complicated procedure or has other health issues, you may meet ahead of time with the HCPs who will keep your child sedated during surgery. Your child may also need additional tests or exams so HCPs can provide anesthesia safely, McCollum says.
Take a pre-surgery tour
Some hospitals offer tours. This lets children who are having surgery see the facility where they will be treated and meet the staff. It also lets them ask questions before the day of their procedure. This is especially useful if your child is having a complicated operation and may have a lengthy hospital stay. Knowing what to expect can help ease anxiety and help your child feel more in control.
If the hospital doesn’t offer a tour, an HCP can explain what to expect and address questions—in a way your child can understand.
Prep your home
After surgery, getting around the house and performing normal daily tasks may be difficult. So, it’s important to alter your home to make recovery as stress-free as possible. Your child’s surgeon or another HCP, such as an occupational or physical therapist, can help you decide what adjustments to make. For instance, you may need to move your child to a bedroom on a lower floor, or move them closer to a bathroom. Make any necessary changes a few days before the procedure.
As the surgery date approaches
In the days leading up to surgery, your healthcare team will give you instructions specific to your child. They will tell you the time of the procedure and when you should arrive at the hospital. You’ll also review the medications your child may take, which meds are off limits, and when to stop eating and drinking. If you don’t receive this advice, follow up with your child’s surgeon or hospital.
Follow fasting rules
To keep food and liquids out of his or her lungs, your child’s stomach needs to be empty before anesthesia. Each hospital has slightly different rules about this. Your medical team will tell you what is recommended in your child's case, McCollum says.
General guidelines are: Older children and teens shouldn’t eat or drink anything other than clear liquids after midnight, or eight hours before anesthesia. Younger kids should avoid solid food six to eight hours before surgery. These include some items you might not think of:
- Candy and chewing gum
- Milk
- Orange juice
Kids—even older children and teens—can have clear liquids up to two hours before surgery. These include any drinks that you can see through and don’t have pulp:
- Gelatin (Jell-O) or one popsicle with no fruit
- Apple or white grape juice
- Sports drinks such as Gatorade
- Pedialyte
- Clear broth
- Water
Infants younger than 1 year old may have:
- Solid food, which includes baby food and baby cereals, up to eight hours before surgery
- Infant formula may be given up to six hours before surgery and breast milk can be given up to four hours before the procedure, according to the American Academy of Pediatrics.
The day of surgery
Bathe your child
Make sure your child has a bath or shower in the morning or before bedtime the night before surgery. If an HCP gave your special wipes to clean the surgical area, don’t forget to use them. Don’t shave any area before surgery. If this is necessary, it will be done in the operating room, McCollum says. If you child is wearing nail polish or artificial nails, these should be removed.
Dress comfortably
On the morning of surgery, dress your child in loose-fitting clothes. Be sure to leave jewelry and other personal accessories at home.
Bring a comfort item
Pack a stuffed animal, book, favorite toy, or blanket. This soothing item will help ease the transition from home to the unfamiliar hospital, McCollum says.
Leave for the hospital on time
If you’re late, the procedure could be delayed or postponed. The surgery center follows specific rules to keep your child safe. These steps take time, and will include the following:
- Hospital staff will go over your child’s health history and make sure all pre-op instructions were followed. They will also take vital signs, which includes listening to your child’s heart and checking their blood pressure and temperature.
- After your child puts on a hospital gown, ask any last-minute questions you have about the surgery. The surgical team may “mark” the spot of surgery on your child’s body with a marker.
- You’ll talk to the anesthesia team and review how your child will be sedated. General anesthesia is either inhaled through a mask or given through an IV. The HCP may give your child medicine to calm nerves prior to starting anesthesia, too. Anesthesia is safer today than ever before. Still, discuss any last-minute concerns you or your child have, including how pain will be managed after surgery.
When it’s time for the procedure to begin, your child will be transported to the operating room. Keep in mind that surgical teams are trained to make this transition as smooth as possible for parents and kids, McCollum stresses. Be calm and reassure your child that you will be in the recovery room when surgery is complete.
