Preparing Your Child for a Hospital Stay

When children hear that they are going to stay overnight in a hospital, they often do not know what to expect. The first step is often to help them to picture what the space will look like.

Parents can help their children to learn about the hospital by:

• watching videos of the hospital, including virtual tours of the rooms

• looking at pictures of the hospital spaces online

• reading social stories based in a child's hospital

• arranging for the child to tour the hospital

Parents can ask children what questions they have about the hospital, and then really listen. Children often wonder about things that adults do not even consider. Parents should answer children's questions truthfully, but not provide more information than the child is requesting to avoid overwhelming them. If a parent does not know, they can assure the child that they will talk with hospital staff to try to find an answer.

Before a child stays in a hospital, parents and providers can help them to know what to expect. Here are some tips to guide that process:

• Talk to the medical team and the Child Life Specialists, and try to learn exactly what the child will experience, in what order. For simple procedures, the staff may be able to tell a family exactly what will happen, and in what order, and feel very confident that it will not change. For more complicated procedures or longer hospitalizations, the staff may not know exactly what will happen. In these cases, the child and family may have to learn to accept a level of uncertainty, and they can focus on the first steps of the process, and what they do know.

• Tell the child what will happen. For a short and straightforward procedure, you may be able to preview the whole hospitalization from beginning to end. For more complex hospitalizations, you can focus on the first steps that you know for sure. Be truthful but reassuring. Focus on what the child will directly experience, and on the details that are most important to that child.

• Read social stories and show pictures from the hospital. Child Life Specialists can help to find or make stories.

• If you can, visit the hospital and walk the child through the different spaces where they will stay.

• Make sure the child knows who will be with them. If a parent may need to leave the hospital, try to make sure the child meets and knows the people who will stay with them.

Parents do not need to have these conversations alone! Hospital staff including social workers, psychologists, palliative care providers, and Child Life Specialists can often help to guide these conversations.

Children do not perceive and understand the world exactly the same as adults. Parents should carefully consider how their child thinks when they decide what to tell them. Here are some tips:

• Young children do not need to know what will happen when they are sedated. Instead, parents can focus on what will happen when they are awake and aware. Older kids and teens may want to know what will happen when they are sedated, but adults can give them that choice.

• Kids often worry a lot about details such as:

  • What will they wear? will they have to change clothes? Will they have to take off their underwear?

  • When and what will they eat?

  • Will they have to swallow any medicines that taste yucky?

  • Will they be able to keep a favorite toy with them? What activities will they be able to do, and when?

• Adults may not have answers to all of these questions, but families and staff can work together to give kids as much information as they can.

• Ideally, kids should be prepared for anything that will be on or in their bodies. For simple procedures, adults may be able to tell kids exactly what to expect. For more complicated procedures or hospitalizations, adults may not be sure what devices will necessary. Adults may want to use less specific language if there is more uncertainty about what will be on or in a child's body. Adults can reassure kids by saying something such as: "These lines and tubes help keep your body healthy. They will come out when your body is ready."

• Using age-appropriate and neutral language, adults can tell kids if and when they may have devices such as:

  • an IV (a tube in their hand or arm)

  • a foley (a tube in their penis or vulva)

  • a bandage or cast

  • staples and/or stitches

  • wires, tubes, and/or drains in their abdomen

  • a tube in their nose

  • an oxygen mask

  • a ventilation tube down their throat, or through a tracheostomy

• People perceive pain more strongly when they are thinking about it and afraid of it. Adults should try not to focus on pain, but can tell kids that the doctors and nurses will work hard and give them medicine to make sure that the children stay comfortable.

• Curious George Goes to the Hospital, by H.A.Rey

• Daniel Tiger Visits the Hospital, by Alexandra Cassel-Schwartz (email CNPschedulingandquestions@childrens.harvard.edu for your free copy!)

• Franklin Goes to the Hospital, by Paulette Bourgeois

• Getting Ready for my Surgery, by Fei Zheng-Ward

• Going to the Hospital, by Amy Kathleen Pittman

• Going to the Hospital, by Ann Civardi

• Going to the Hospital, by Fred Rogers

• Helping Hospital, by Lindsay Ward

• The Hospital Dog, by Julia Donaldson

• Look Inside a Hospital, by Katie Daynes

• Magic Air: Ten Kid-Sized Steps to Surgery, by Alana Smith

• Maisy Goes to the Hospital, by Lucy Cousins

• A Trip to the Hospital, by Freda Chiu

These videos can help children and their families to prepare for a hospital stay.

Children learn through play. Medical play can help children to feel comfortable with objects and experiences that they will encounter in a hospital before they even walk through the front door. It can give kids a sense of ownership and control in a medical setting, and reduce feelings of fear and helplessness.

Families can ask Child Life Specialists how to find appropriate materials for medical play. Families can often find authentic materials in their local pharmacy, and children can also play with toy medical kits.

Medical play should always be supervised by a trusted adult.

Here are some ideas for medical play:

• Blow up hospital gloves to make balloons

• Fill oral syringes with paint and squirt them onto paper

• Play "hospital" and treat a doll or stuffed animal

• Use glue and tongue depressors to make sculptures

• Use medical tubing to blow bubbles or squirt water

• Make collages with medical tape, stickers, and bandages

• Decorate, cut, and glue hospital robes and gauze to make fun clothes or hats

• Make butterflies out of gauze and bandaids

When children help pack a hospital bag, they can increase their sense of agency and control. They also gain a better sense of what to expect during their hospital stay, and may feel reassured that they will have comfortable and familiar objects around them.

Families should check in with their hospital team to be sure what to bring. Depending on the age of the child and the length of the hospital stay, families may want to pack:

• a comfort item such as a special stuffed animal, doll, pacifier, or blanket

• loose, comfy clothes for varying temperatures, including clothes that open in the front

  • adaptive clothes will have more options for tubes and wires, if needed

• distracting activities (games, crafts, books, videos, puzzles, small toys)

• a computer or tablet

• chargers for all devices

• warm socks with grippy bottoms

• slippers with solid soles

• flip-flops for the shower

• sound-protecting earmuffs or ear plugs

• headphones

• playlists of music

• a sleeping eye mask

• their own toothbrush and toothpaste

• their preferred body care: face wash, soap or shower gel, shampoo, conditioner

• a hairbrush or comb

• dry shampoo

• XL twin size sheets (for hospital beds), and twin size sheets (for parent sleeping spaces)

• their own pillow and pillowcase

• a comfy blanket

• a water bottle

Children feel better at the hospital when they have some choice and control. Before going to the hospital, parents can talk with hospital staff about what choices the child might be able to make. Then, the family and hospital staff can talk to children about these choices, and their preferences.

For shorter and simpler procedures, hospital staff are often very confident about the choices children will be able to make. For more complicated and longer hospitalizations, children's opportunities for choices may be unpredictable, and may change from day to day. Parents and hospital staff can help children to understand that sometimes adults may not be able to stick with the child's choice, but that they will do the best they can to respect what the child prefers. They can also promise to keep the child informed, to tell them what they are doing while they are doing it, and to allow children to share their opinions whenever they want.

Depending on the procedure, the time of day, and a child's condition, children can sometimes make choices about decisions such as:

• where and when adults have conversations about their care

• if and how adults ask permission before touching the child's body for non-essential care

• how adults update them about their care and condition

• whether and how adults tell them what they are going to do before they do it

• whether they want to avoid certain non-necessary sensations, if possible

• the flavor of inhaled anesthetic

• how they want to take certain medicines, and if/how they want them flavored

• what they wear

• when and what they eat

• where they have an IV or other needle

• where they want to be, and how they want to be positioned for procedures like taking vitals and changing IV fluids

• how adults enter their room (knock first? announce their name? be quiet?)

• how their room is decorated

• lights and sounds in the room

Preparing for a hospitalization can bring up big feelings for everyone in the family. Parents should try to take care of themselves and each other, as well as all the children in the family. Therapists can often help both children and adults to feel calmer and more in control. Families can reach out to their care teams to find additional sources of support.

This content was reviewed by a psychologist at Boston Children's Hospital.

Developmental care is best when it is local. Families local to Boston can receive support from the Cardiac Neurodevelopmental Program, Child Life, Spiritual Care, Social Work, and/or the PACT team. Families from other regions can click below to find their care team.