Preparing Your Child for a Hospital Stay

When your infant is hospitalized, it can be strange and frightening. In addition to overall anxiety, you may feel upset because you cannot care for your infant like you do at home.

Here are suggestions for how to care for your baby as much as possible during hospitalization. 

Caring for you baby during a hospital stay:

• Please tell your nurse if you are a breast feeding mom.  We have resources available to support you.
• Let your baby’s nurse know you would like to be as actively involved in your child’s care as possible. For example, you can assist the nurse during your child's diaper change, bathing and feeding.
• Talk, sing or read to your child as often as possible.
• Use positive touch with your child to let him or her feel your presence.
• Play with your child as much as possible.

Making your child's room more comforting:

Very often, items from home can help calm your baby during his or her stay.  Please talk with your child's nurse before bringing items from home. 

If you cannot be at the hospital with your baby:

• Record your voice or other familiar sounds, such as singing, talking, or reading stories.
• Let caregivers know your child's likes and dislikes. For example, "When I get upset, please try to soothe me by _____________." Or, "I really like when you ______________."
• Let caregivers know routines you and your child follow. For example, "Please change me before you feed me." Or, "At home, my mom plays music while she feeds me."

While in the hospital, your baby may have changes in behavior, including:

• Sleeping more or less than usual
• Clinging to parents
• Exhibiting separation anxiety
• Wanting to be held more than normal or not wanting to be held 
• Sensitivity to light, temperature or touch
• Increased crying 
• Stranger anxiety 
• Decreased appetite

Speak with your nurse with any concerns. Contact the child life specialist on your unit if you would like help addressing these responses.

Children respond differently to hospitalization depending on the length of stay, the procedures involved, and any recent stresses. Sometimes even a recent family move or the birth of a new baby can make it stressful for your toddler to adjust to hospitalization.

When to talk to your child about a hospital stay: Two or three days before admission

What your child may be concerned about: Being away from home — and potentially being away from you — are typically the most stressful parts of hospitalization for a toddler.

How you can help:

• Talk to your child in simple terms about the upcoming hospital stay. Ask your child what questions he or she has.
• Answer any questions simply and honestly. For instance, young children may ask, "How long will I be there?" or "Will it hurt?"
• Read a book to your child about being in the hospital. You can often find these books at your local library.
• Let your child know how often and when you will be at the hospital. Be realistic. It is not helpful to try to reassure your child by saying untrue or inaccurate statements.
• Have at least one parent or family member stay overnight with your child if possible.
• Work out a plan with your child's nurse to allow you to continue caring for your child as much as possible, such as when bathing, changing clothes and feeding.
• Give information to the nurses about your child's routines, likes and dislikes, etc., if you can’t stay overnight. This will help your child adjust better.

While in the hospital:

• Your child may express emotions through crying or anger. Toddlers have difficulty expressing feelings. Because of this, your child may cry and direct anger toward you. This does not mean you are upsetting your child. Your child feels comfortable and secure enough to express these confused feelings to you — and perhaps at that moment, only you.
• Offer your comfort and reassurance. As difficult as it may be, try to keep in mind that you are, in fact, the most important person for your child at that time. Your presence, comforting words and reassuring smile will help your child adjust to this new environment.
• Your toddler's behavior may backslide while in the hospital. For example, if your child has recently been toilet trained, he or she may start having accidents again. Or, your child may refuse to eat and have more tantrums than usual. These are normal responses to being in the hospital and in a stressful situation.
• Remember to care for yourself as well. The long hours and stressful conditions may cause you to feel anxious or exhausted too. Remember to take care of yourself so you can take good care of your child. Take breaks during the day to nap, relax, catch up on work, or visit with the rest of your family. Your nurse can discuss ways to take breaks throughout the day.

Hospitalization can be a stressful experience for a preschooler. However, the preschooler has acquired some good verbal skills, and may be able to ask more questions regarding the hospital experience.

When to talk to your child about a hospital stay: Three or four days before admission

What your child may be concerned about:

• Preschoolers often have misunderstandings about hospitalization. At this age, children may think they are being sent away because they have done something wrong.
• They will likely also have the same fears as a toddler about being separated from you and home, or about potential pain.

How you can help:

• Talk to your child in simple terms about the upcoming hospital stay. Ask your child what questions he or she has.
• Offer simple explanations. Children in this age group can understand explanations such as, "The doctor is going to fix your heart.” Or, "The doctor needs to do a test to see why your head hurts."
• Read a book about a hospital stay with your preschooler. Allow questions and comments from your child while reading and looking at pictures.
• Reassure your child that he or she has not done anything wrong and has not caused the illness in any way. The guilt many preschoolers experience is usually reduced with discussion and explanation.  
• Bring pictures of family, pets or other loved ones to the hospital. Your child may miss siblings, pets or other family members while in the hospital.
• Encourage your child to play “hospital.” Imaginative play is a big part of most preschoolers' lives. Your child can use bandages and other medical toys on dolls or stuffed animals.
• Allow your child to express any feelings he or she may have during play: It’s a good chance to learn any misunderstandings, fears, or frustrations your child has that he or she may not otherwise be able to communicate.

While in the hospital:

• Your child may express emotions through behavior. No matter how much preparation occurs, hospitalization can still be stressful for your preschooler. Your child may not know how to say, "I am angry," or "I am frustrated and sad.” Instead, your child will likely express these feelings through behavior. Typical behavior includes:
  • Having temper tantrums
  • Refusing to do necessary things
  • Whining and crying
  • Being very demanding
• Acknowledge your child’s feelings. You can help your preschooler by acknowledging feelings while still setting limits. For example, "I know you are angry, but I can’t let you throw that."
• Your preschooler may become angry at you. This is usually confusing to parents, because they are not the ones causing the stressful situation. Remember that your preschooler knows that you are trustworthy and that you will still love him or her. Your child feels comfortable enough with you to express him or herself.

Unlike the toddler and preschooler, school-age children usually are more capable of understanding explanations regarding tests, surgery, and changes in routine. However, fears about separation and illness are still very much a part of the hospital experience for school-age children.

When to talk to your child about a hospital stay: One to two weeks before admission, typically. How much time a child needs for preparation differs for each child. Parents can usually tell how much time is needed.

What your child may be concerned about:

• Many children this age fear that their bodies will change as a result of a test or surgery. They also may fear damage of a body part.
• School-age children may also fear that they are being punished for some wrongdoing.
• School-age children may worry that their friends won't know where they are or won't care about them anymore.

How you can help:

• Reassure your child about any concerns over body changes. Use statements such as, "The doctor is going to fix the small hole in your heart, but will not change any other part of your body."
• Include pictures of family and friends when you and your child are packing. These reminders are important for school-age children during hospitalization.
• Read a book about hospitalization together — or encourage your child to read one — to become better prepared.
• Answer any questions that may arise with honesty and reassurance.

School concerns:

• If your child is expected to be in the hospital for more than two or three days:
  • Arrange to bring school books and assignments from your child’s teacher.
  • Through the Hospital School Program, teachers at the hospital supervise school work daily. They can work with your child's school teacher, as needed.
• Before admission, talk to your child's teacher and friends. Ask if will they send letters and cards to the hospital. This can help your child's adjustment during and after hospitalization.
• If your child cannot return to school immediately after discharge, he or she may be eligible for a homebound teacher. Ask your Hospital School Program teacher for assistance, if needed.

While in the hospital:

• Telephone calls can help your child feel more comfortable. You and your child's friends may phone at any time. However, no calls are sent to patient rooms after 10 p.m. to allow patients to rest.  For your child's safety and health, friends younger than 15 are not allowed to visit. 
• Don’t be alarmed if your child does not answer the telephone. Your child may be getting an X-ray, visiting with nurses, or in the playroom. You may call the nurses' station to ask about your child’s condition or any other questions you have.  
• Encourage your child to visit the Child Life Playroom to engage in familiar activities with peers. The playroom is open during the day and evening.
• You may notice behavior changes in your child. For example, your child may become quiet or angry during the hospitalization. These are normal responses to stress. Contact the child life specialist on your unit if you would like for more information about how to address these responses.

Hospitalization is often as stressful for teenagers as it is for young children. However, they may be stressed by different things. For example, adolescents have an increased need for socializing, and hospitalization separates teenagers from family and friends.

When to talk to your child about a hospital stay: A teenager can typically be told up to two weeks in advance. Older children are usually more aware of the medical issues leading to the hospital stay. The amount of time a child needs for preparation differs for each child. Parents can usually tell how much time is needed.

What your child may be concerned about:

• Being separated from family and friends.
• Loss of privacy; teenagers are typically private about their bodies, thoughts and feelings.
• Loss of independence or control over his or her body and environment.
• Feelings of insecurity, including feeling like something is wrong with his or her body and that it may never be the same again.

How you can help:

• Try to arrange for friends to come visit, call or text your teen during the hospital stay to reduce feelings of separation.
• Encourage your teen to stay active and participate in his or her own care to decrease the sense of a loss of control. Our child life specialists will also provide choices whenever possible to help your teenager maintain some control during hospitalization.
• Respect your teen’s privacy at all times. Encourage your teenager to pull the curtain around the bed for privacy, whenever desired. Medical staff will not perform embarrassing or painful procedures in the Teen Lounge or any other public area.
• Recognize that body image is important to adolescents. Because of this, talk to your teenager openly about the procedures and what will happen during them.
• Encourage your teen to ask questions about expectations, including making a list to bring to the hospital. Our staff will be happy to answer any questions.
• Ask to have a tour of hospital areas your teen is curious about after your teenager is admitted to the hospital. The child life specialist on your unit can arrange these tours.

School concerns:

• If your child is expected to be in the hospital for more than two or three days:
  • Arrange to bring school books and assignments from your child’s teacher.
  • Through the Hospital School Program, teachers at the hospital supervise school work daily. They can work with your child's school teacher, as needed.
• If you child cannot return to school immediately after discharge, he or she may be eligible for a homebound teacher. Ask your Hospital School Program teacher for assistance, if needed.

While in the hospital:

• Your teen can visit the Teen Lounge. The lounge has a surround-sound stereo, Wii, XBOX 360, PlayStation, and computers. Activities in this area give teens a chance to maintain independence and connect with peers while in the hospital.
• Encourage your teen to participate in arts and crafts projects in the Teen Lounge and other planned activities geared to patients over 12 years of age.