If your child is going to the hospital it helps to find out as much as possible ahead of time what will happen there. It will give you an opportunity to prepare her emotionally for the experience, and you can reduce the stress for the both of you.

It's important to keep in mind that what your child fears most is being separated from you. If your doctor gives you a choice, it is best to avoid an overnight stay before a scheduled surgery. What's most important is if she does have to stay in the hospital overnight, that you are allowed to stay with her. That really makes a difference. More hospitals these days can arrange for that.

Each hospital is a little different. You can find out just how the one you will go to works. We suggest that you call the hospital and ask to talk with the nurse manager or head nurse for children's surgery. Some hospitals have family service workers or volunteers that can answer your questions and be available to you throughout the process. Don't be afraid to ask questions about the exact details, such as where to go and how the admitting system works. It can be very confusing when you first come into the hospital. Then you'll want to know where you will go next. Usually there is an area called surgical admitting. Is there a separate place for children? Will you be able to undress her and be with her there? The next step would be going to what's called the pre-op or holding room. You can ask what that is like. Is there one just for children? Does it have a play area? Mainly, can you stay there with her?

Hospitals do vary a lot according to the size and also if they handle many children. Usually adults receive some medication and even intravenous fluid in the pre-op room but that might not be the case for children. The needles and medicine may only occur once she is in the actual operating room. So it's important to ask about that. Intravenous fluids are pretty automatic in all surgery. But you need to go over this some more with your doctor.

What is particularly upsetting for a child is the combination of the strange hospital, the idea that something is going to be done to her body, and then being separated from Mommy and Daddy. Some doctors and hospitals have worked out a system to make this as unstressful as possible. When they can they try to use a medicine even in the waiting period, before a child has to be separated from her parents so she will become drowsy and less fearful about what will happen. Your doctor will have talked with the surgeon and the anesthesiologist about the way they do this and should be able to tell you the details.

It's best not to overload your child with information way ahead of time. Of course some children have seen books about hospitals or have even heard other children talk-- but even so its different on the scene. We recommend that a couple of days before, you begin to tell her what will be happening, for example that she will be going to the hospital to have her ears fixed. You should drive by the hospital and show it to her. Emphasize the positive. But don't overdo it either.

Then the day before, you can be more specific and tell her she'll be in a room where other children go to have that particular problem fixed by a doctor and a nurse who will help. Show her the part of her ear or body that will be fixed.

At the hospital there usually is a period of waiting-- you should be prepared for that-- so bring something to play with until she's called. Its really best if you can request to have the surgery done first thing in the morning. She wont have had anything to eat or drink and also she won't have to wait so long.

Then you can talk to her about what will happen. Tell her she may need a shot in her arm but it won't hurt much and it will make her feel sleepy. Don't forget to tell her what things will be like when she wakes up. For example, she might have tubes in her ear, or an I.V. or a cast. Explain to her what they are and how they work to help her.

Usually there is a recovery room right next door to the surgery and in most hospitals parents are called into it once the anesthesia has worn off. That may take a quarter of an hour or so. It helps to realize that your child won't remember the actual procedure and that she will be foggy for a while even after she awakens. You will want to ask the nurse manager how it works. When can you go in and how long can you stay?

You may wonder what to do if your child starts to cry or gets anxious. That's a normal reaction for a child-- it isn't bad. So let her cry-- you can soothe her. She needs to let that emotion out. Also be sure to ask if she can bring her favorite blanket or stuffed animal along and if they allow her to have it in the operating room. Most hospitals for children now go along with that. If they do, you can keep reminding her that she has her blanket and that you will be in the next door room while they are fixing her ear (for example).

Remember young children don't have a very good sense of time, and surprisingly they sometimes do think they will be in the hospital forever. That's why it's important that their mom or dad tell them about when they will be going home.

What happens after the surgery depends on the hospital. You will need to ask. Probably your child will be taken to a recovery room. There may be other children there. It is by far the best if you can be there with her. Hospitals have come to realize that in most instances the recovery goes more smoothly if a parent can be in the room. After the recovery she will go home with you if that is the plan. But she may be there with you for a few hours.

It's a great idea to make a picture together about the whole experience. Also some hospitals have books which the nurses read to the children before the surgery. You may wish to check your local library for a book about going to the hospital. Some parents use a toy doctor's kit to play out the experience with dolls. But not all children take to that and its important not to push it.

You can go over some of what we have talked about with your pediatrician- especially about the holding room and the recovery room policy at your hospital. Also whether your child can take her blanket with her to the surgery. Ask whether a visit to the hospital before surgery is possible.

Its important to keep in mind that after the surgery, you'll get a second chance to go over what happened with your child and to tell the story again. In fact, it's very helpful to a child to hear it over and over. Also you may discover she has some confused ideas about what it was all about. Ask her some questions-- like "why do you think they did that?" or "what was the I.V. for?" You can help her if she's mixed up. That will help her memory of this be a positive one.

Take your cue from your child as to when to talk about it. Some children need to talk about their experience right away, others talk about it very little and come up with questions unexpectedly a few days later. Then you can slowly go over the whole experience- the room, the medicine, the nurses and how everything happened.

Tell her that she has a strong body and that she was able to take the medicine and surgery very well. Let her know that she cooperated even when she was scared and even when she was angry about what was happening. Acknowledging not only her fear but her anger can be a relief to her. Telling her how well she managed her experience will give her a proud feeling about herself.

Remember your child's greatest fear is being separated from you. The more you can be present during the experience-- the less stress for her and for you. Be sure she understands that she will be asleep while the doctor does the surgery and she won't have to feel pain. Be available as soon as possible after the surgery, in the recovery room if possible, or in her room. And at home afterwards, go back over the events from time to time to see if she needs to talk about what happened or straighten out any mistaken ideas she may have about the surgery.

If you would like guidance on this or any other non-medical child development question, and you live in the Los Angeles area, you can call the Warm Line free of charge at 310-281-9770. A child development specialist will return your call within just a couple of days.