Pediatric Surgery Guide
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This post was in partnership with Ann & Robert H. Lurie Children’s Hospital of Chicago, but all of the opinions within are those of The Everymom editorial board. We only recommend brands we genuinely love.

You Asked, We Answered: Your Burning Questions About All-Things Pediatric Surgery

plus, experts share 10 tips parents should know before their child's surgery

No part of parenthood is meant to be endured alone, especially the unknown bits that leave you anxious and unsure, like an upcoming surgical procedure for your child. And even though our generation’s constant access to information can be overwhelming, it can also be a powerful tool under the right circumstances. If your child is undergoing pediatric surgery soon, you’ve got a lot of questions—and we’ve turned to the experts for answers.

For half a decade now, The Everymom has strived to be a go-to resource for whatever kind of motherhood moment you’re in: the good, the bad, the scary. We’ve put together a comprehensive guide with the help of the medical experts at the Ann & Robert H. Lurie Children’s Hospital of Chicago’s Division of Pediatric Surgery and Division of Pediatric Anesthesiology to ease your worries regarding common surgical procedures. We recently turned to you, our readers, and collected your most pressing questions about pediatric surgery so the leading surgeons and anesthesiologists at Lurie Children’s could answer them directly. And they also provided 10 tips parents should know before their child’s surgery. Read on for their answers below!

Answering Our Reader’s Questions on Pediatric Surgery

One thing about us? We’re going to get to the bottom of the burning questions you have for your kiddos. Below and with the help of experts from Ann and Robert H. Lurie Children’s Hospital of Chicago, we’re breaking it down and connecting you with everything you need to know.

Meet the Expert

Timothy B. Lautz, MD

Attending Physician, Pediatric Surgery; Director, Surgical Oncology

Meet the Expert

Rashmi Kabre, MD

Attending Physician, Pediatric Surgery, Director of Trauma Services

How do you deal with fasting for a 15-month-old before surgery?

Before surgery, our fasting requirements are not as strict as people think. It’s eight hours for any solid food, six hours for formula, four hours for breast milk, and only one hour for clear liquids! That means they can have Gatorade, apple juice, or even water up until one hour before surgery.

We try to schedule the younger kids earlier in the day so they’re not “hangry” for too long. Our child life team is usually excellent about redirecting the kids’ energy with Play-Doh, Legos, coloring, movies, or apps. It’s not perfect but definitely tolerable. Patience and redirection are key with children this age no matter what’s involved, whether it’s surgical or non-surgical!

I have a 19-month-old with UPJ obstruction—standard treatment, what’s post-op recovery like?

A procedure called robot-assisted laparoscopic pyeloplasty is the standard treatment for UPJ obstruction at Lurie Children’s and at most higher volume pediatric centers with experienced robotic surgeons. Regarding recovery from this procedure, most children do not require prescription pain medications after hospital discharge (which is usually about 24 hours post-op), and many don’t even need over-the-counter pain meds. There are no activity restrictions, and kids are typically back to normal in a day or two.

However, if the child has a more traditional open surgery for the condition, he or she may need pain medications for two to seven days post-procedure. At 19 months, there would be few specific activity restrictions (older kids would be restricted from gym, sports, etc.). The child will probably be feeling back to normal somewhere between five to 10 days after surgery.

How do you ease recovery and minimize pain in a 3-year-old after a tonsillectomy/adenoidectomy?

Good hydration is key following the procedure, so your physician may recommend increased fluid intake. There aren’t likely to be any major dietary restrictions, but it’s generally more comfortable for children to swallow softer solids than crunchy foods after surgery. A pain medication regimen will be recommended by your physician after surgery, usually including acetaminophen and ibuprofen. The throat can be sore for seven to 10 days after the procedure, so pain management is essential.

pediatric surgery
Credit: Ann & Robert H. Lurie Children’s Hospital of Chicago

How common is ear tube surgery?

Ear tube placement is the most common surgery on children in the U.S. Every year about a million children, usually aged 1-3, have tubes placed in their ears. The risk for ear infections and subsequent tubes is higher for children in daycare. According to the latest guidelines on recurrent ear infections in children, one in 15 under age 3 have tubes, and the risk of infection doubles for kids in daycare. If you have more questions, check out our guide on ear tube surgery here.

Can you talk about umbilical hernia surgery?

Everyone is born with an umbilical hernia that usually closes by 3 to 5 years of age. A hernia is an opening in the fascia, which is the strong layer below the skin. The external sign of an umbilical hernia is often an “outie” belly button. Except in a few rare circumstances where the hernia causes symptoms, or if the skin is stretching out too much, most surgeons will wait until at least 3 years of age before recommending surgery in order to give plenty of time for the hernia to close on its own. When surgery is performed, it involves a small 1-2 cm incision below the belly button and all stitches are hidden below the skin. It’s a same-day surgery, and children are usually up and running around by two or three days after surgery.

Umbilical hernias in kids can be repaired very simply with dissolvable stitches that bring their own tissue together. In contrast, adults often require a more complex repair involving mesh. For that reason, we often recommend repair in childhood, even if the hernias are fairly small.

My child is having tethered cord surgery–how can I be better prepared?

The goal of tethered cord surgery is to delicately remove the tissue that is preventing the spinal cord from moving freely while stabilizing, and hopefully improving, neurological function. This surgery can range anywhere from an hour and a half to six hours depending on the case and is performed by a Pediatric Neurosurgeon.

Post-operative risks for this surgery include infection as well as cerebrospinal fluid (CSF) leak. Because the incision for this surgery is on the lower back, it’s important to keep the child’s diaper clear of the healing incision. Depending on the case, CSF leakage (a bodily fluid that surrounds the brain and spinal cord) can occur so the Pediatric Neurosurgeons will promote limited activity afterward.

How do you help an anemic toddler and give them iron supplements when they’re being resistant?

Generally speaking, medicines can often be added to liquids or hidden in food in powder form, if possible. Most liquid medications can be flavored by pharmacists and sometimes different flavors can be chosen, but we really don’t deal much with iron supplements. That’s more of a pediatrician thing.

pediatric surgery
Credit: Ann & Robert H. Lurie Children’s Hospital of Chicago

Will I be with my child before surgery?

You will be with your child when you arrive and while the pre-operative nurse, anesthesiologists, and surgeons come talk to you in the pre-operative area. Once the surgical team is ready to head to the actual operating room, you’ll remain in the pre-operative area or waiting room. Except in rare circumstances, parents are not typically able to go into the operating room with their child because we want to make sure we maintain the strict sterile conditions in those rooms.

However, if your child is nervous about going to the operating room without a parent, there are several different options available. Child life specialists can accompany your child to the OR, and they’re outstanding at providing distraction, calming anxiety, and explaining everything to children. We can also give a “pre-med” to the child before they leave their parents to head to the OR, which is an oral medication that calms the child and also causes them not to remember the trip to the OR. You can talk to your pre-operative nurse and anesthesiologist about which options are best for your child.

During short surgeries, you may remain in the waiting room or pre-op area and the surgeon will immediately come find you when they’re done. During longer surgeries, you will usually be told when you have time to grab food/coffee/drinks. Surgeons are best at estimating the length of the procedure, and it’s quite appropriate and accepted to ask your surgeon this question pre-operatively. You’ll talk with your surgeon post-operatively and typically after this occurs, you’ll be allowed to see your child about 15-20 minutes later in the recovery room.

My toddler frequently gets nursemaid’s elbow (hyperextends the ligament) when he plays too rough. Is there any way we can prevent this or help protect his ligament if he wants to play sports when he’s older?

Avoid the activities that cause the nursemaid’s elbow, as recurrence can be high and prevention is the best medicine. However, this alone is unlikely to prevent your toddler from sports participation in the future as the annular ligament will tighten up with age. Dr. Larson discusses this condition more in this clip: Playtime can lead to common elbow injury in children.

What are some everyday items in our homes that can commonly lead to a child injury?

Everything! Children can turn everything into something harmful! That being said—here’s a quick list:

  • Toxic cleaning solutions within reach of children without child locks
  • Medications improperly contained and not locked up (even Tylenol and Motrin can be dangerous in high doses)
  • Bathtubs (children can drown in even inches of water, never leave unattended)
  • Batteries (ingestion may cause esophageal erosion and sometimes tracheal injury as well)
  • Magnets (may cause intestinal erosion/fistulas)
  • Stoves and ovens (burns)
  • Hot water from faucets or even spills from drinks (may cause severe burns)
  • Stray or even household dogs (dog bites)
  • Stairs (running fast and falling down)
  • Trampolines
  • Bicycles (especially without helmets)
  • Hoverboards
  • Nerf guns (eye injuries), BB guns (penetrate tissue in children), and hand guns that are in homes
  • Fireworks (eye injuries and burns)

What precautions can we take to avoid common at-home injuries?

  • Never leave children alone or unattended; keep medicines, hazardous chemicals, and batteries locked up or out of reach. 
  • Don’t buy magnets!!!
  • Teach children safety around pets/animals and be watchful when near them.
  • Utilize helmets!
  • Lock up all guns and keep key/codes in separate area from the actual gun locker.
  • Use eye protection with Nerf guns and consider doing the same around fireworks if you’re close to where they’re being set off.

10 Tips Experts Want Parents to Know Before Their Child’s Surgery 

In this section, a doctor explains 10 helpful things parents should know about pediatric surgery and how you can best prepare yourself and your little one for the operation.

Meet the Expert

Dr. Alison Robles

Attending Physician, Anesthesiology

Meet the Expert

Dr. Olutoyin Olutoye

Anesthesiologist-in-Chief, Department Chair, Pediatric Anesthesiology

1. Take care of yourself

Making sure you have nutritional food and that you’re addressing your own needs will better equip you to care for your child.

2. Pack a bag

Include a few of your child’s favorite things, comfort items, and activities for you both to do while you wait.

3. Bring a phone charger

You may be using your phone more than usual, and it will be important to have plenty of charge so that you’re accessible throughout the day.

4. Yes, you will need to wear a mask

Most hospitals have a masking policy in place. Check with your local hospital about the specifics of their policy and be sure to adhere to them during your visit. 

Credit: Ann & Robert H. Lurie Children’s Hospital of Chicago

5. Play pretend with your child

Practice walking through and role-playing things that will happen throughout the day with your child. Pretend that you’re taking their vital signs (e.g., blood pressure, temperature), checking their weight, or asking questions about their health.

6. Make sure your child gets a snack before they go to bed the night before surgery

Giving your child something to eat right before their mandated pre-surgery fasting hours is a good idea. Going without food and drink is hard for children (and adults!). Minimizing the amount of time they have to go without eating can improve your child’s ability to get through a long day.

7. When talking through the procedure with your child, do so in a calm and open way

Be thoughtful about the language you use. Avoid sharing your own fears, concerns, or strong emotions with your child.

8. Ask for a child life specialist

Child life specialists are specially trained professionals in many children’s hospitals who act like teachers. They can help explain things in a developmentally appropriate way and create a coping plan for you and your child. Sometimes they also have fun activities or things to play with.

Credit: Ann & Robert H. Lurie Children’s Hospital of Chicago

9. Make friends with the nurses

They’re the ones who’ll be spending the most time with your child. They can communicate any concerns that come up to the doctors, give you tips on where to find food, and grab your little one that extra warm blanket or another popsicle. Be sure to thank them and give them the respect and appreciation they deserve.

10. Have some flexibility

Know that things may not go as planned. It’s good to plan for the unexpected and control the things you can control, but life has a way of always throwing curveballs. There may not be any spots left in the parking garage, or your child’s surgery might be delayed. Going with the flow is good for your own mental well-being.

About Ann & Robert H. Lurie Children’s Hospital of Chicago

Led by a team of world-renowned pediatrics experts, Lurie Children’s is the #1 pediatric hospital in Illinois and an institution we trust for all things kids’ health. With 140 years of clinical expertise, research, and community engagement, the team at Lurie Children’s is committed to putting children and their families at the center of everything they do. We are honored to partner with Lurie Children’s to help educate our readers about how we can help our kids lead a healthier future. Learn more about Lurie Children’s and find a doctor near you today!

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This post was in partnership with Ann & Robert H. Lurie Children’s Hospital of Chicago, but all of the opinions within are those of The Everymom editorial board. We only recommend brands we genuinely love.