Hospitals can be strange places for young children. On a visit to hospital, they will encounter lots of different people in an unfamiliar environment. There will be many new things to see, hear and smell and there may be lots of waiting. Along with the general disruption this brings to the normal routine, all these things can make hospital visits stressful or overwhelming for young children and their families.
This page from Great Ormond Street Hospital (GOSH) aims to give you some reassurance and a few ideas for how you could approach them. All these suggestions come from our play team, who between them have many years of experience working with children, young people and families in hospital. If you have any particular tips or methods that have worked for you, please contact us to tell us about them.
When to tell your child about a hospital stay or visit
It can be difficult to know when to tell a young child that they are going to hospital. Time is experienced and understood in different ways by young children. However, it is always better to prepare them in some way, rather than not telling them anything at all. This would probably be more unsettling for them.
As a rough guide, we would suggest telling younger children about a hospital appointment a day in advance and to start preparing children for a hospital admission (involving at least a one night stay) up to a week ahead, keeping the explanation you give the same each time. It may be helpful to count the number of days (or sleeps) if they are keen to know when the hospital visit will happen – possibly using a calendar or visual countdown picture.
What to say
You know your child well so you are the best person to decide what you say and at the right level for their understanding. Balancing the right amount of information and detail to give can be a challenge. Young children may not be able to take in new information about unfamiliar places and experiences. However, it is not recommended to keep your child’s hospital visit a secret or say that it won’t happen.
The main worry for young children will be separation from their parents and main carers. It is important to reassure them that you will be with them during their hospital visit.
Reassure your child about what to expect at GOSH. You can visit our website for a ‘virtual tour’ and information about each ward, which may be helpful.
Preparing for a hospital stay
Use toys to ‘play hospital’
Hospital play can help your child understand what may happen during a hospital visit. They may feel more prepared or be able to express feelings if –during play – their favourite teddy or doll also has the same things done. You could play too, by pretending to examine favourite toys, sticking on plasters, taking their temperature or listening to their heart. Hospital play kits are also available to buy, often containing toy stethoscopes and syringes.
Stories and television
Books are widely available that help children understand what happens at the hospital. These are either factual information books about hospitals or story books about a character having an operation or visiting the doctor or dentist. Have a look at some of the suggestions at the end of this information sheet or talk to the Children’s Librarian at your local public library.
Some children’s television programmes feature stories or information about our bodies, health and hospitals. Again, see the suggestions at the end of this information sheet
Practice makes perfect
If you know that your child is going to have a particular procedure in hospital, it can help to talk about this or even to practice certain aspects at home first. For example, many procedures need your child to stay very still for a short time – you could play ‘sleeping lions’ or a ‘statues’ games to practise, gradually increasing the amount of time your child can resist moving. Recalling the game you have practiced may help during your child’s procedure.
During a hospital stay
Most toddlers will worry about being away from their main carers. GOSH encourages one parent to stay with their child throughout their hospital stay (both parents if the child is in intensive care). Reassure your child that you will be with them and that you will be sleeping in the same room as them. Your child may seem more clingy or anxious during a hospital stay. They may need more reassurance and more cuddles than usual.
During hospital stays all parents are encouraged to take regular breaks from the ward environment. Taking a break and taking time-out for yourself can help with the stress of caring for a sick child. When you are having a break from the ward, tell your child’s nurse - and also tell your child - when you will be back and try not to be late. If you do get delayed, call the ward so they can reassure your child that you are on your way.
Some parents cannot stay with their child all the time. This may be because of family, work or other commitments. If this issue affects your family, please discuss this with your child’s nurse on the ward or at their next hospital appointment.
Keeping to a routine
While it can be tempting to be less strict about what happens and when, your child will probably prefer to stick to their usual routine during a hospital stay. The familiarity of usual mealtime and bedtime routines can be a source of comfort for young child when they are away from home.
Helping your other children cope
Changes to everyday family routines can be unsettling, especially when a parent and brother or sister is away from home for any length of time. This will have an effect on other children within the family.
GOSH have produced an information sheet specifically addressing the experiences of siblings when their brother or sister is unwell or has additional needs. This gives some suggestions on how to help your other children cope. Please ask for a copy or find it on our website.
After a hospital stay
Young children often process and react to their illness and hospital treatment when you return home after a hospital stay. You may find they are more clingy, tearful or anxious than normal. Some children seem to regress or go back a few steps in their development.
You may notice some disturbances to their sleep, appetite or eating, or using the toilet. They may return to sucking a dummy or need a comforter more than usual. These are all normal responses to the changes in their routine and should settle down soon after returning home.
If you are concerned about your child’s behaviour, ask your family doctor (GP) for advice or contact one of the organisations at the end of this information sheet.