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Women and Children Services Pediatrics

 
Children’s Reactions to Hospitalization
My child is in the hospital... is this normal?
Common reactions of children to the hospital environment;
And, ways that you can help your child cope.


Infants

Reactions:
  • Crankiness and irritability caused by a disruption, or change, in their normal routine
  • Infants have an immediate reaction to pain or discomfort
  • Infants may not be able to verbalize their feelings, but can show their feelings through their actions (withdrawing from interaction, eating or drinking less than usual, crying, sleeping more or less than usual)
  • Stranger anxiety usually begins at about 6 months of age; being separated from a caregiver can be extremely difficult for an infant in the hospital

What you can do:
  • A favorite pacifier may provide some comfort
  • A familiar blanket
  • Soothing music


Toddlers

Reactions:
  • Fear of strangers
  • Separation anxiety
  • Toddlers often have an immediate physical response to pain and unfamiliar surroundings, such as crying
  • A regression in established skills, for example, use of baby talk, wanting to be carried, or refusing to use the toilet

What you can do:
  • A favorite blanket
  • A favorite stuffed animal
  • A familiar object may provide some comfort


Preschool-Aged Children

Reactions:
  • Separation anxiety; fear of what might happen when a caregiver is not there
  • Display increased magical or fantasy thinking; fear that hospitalization is a punishment or was caused by something that he or she did or didn’t do
  • Fear usually regarding things that hurt, such as shots; that having a shot is a punishment
  • Fear that an action caused the illness to occur, leading to feelings of guilt
  • Regression of skills

What you can do:
  • Reassure the child that nothing he did caused the illness
  • Avoid threatening tests or procedures as a punishment, this can cause a later avoidance of seeking medical care or not admitting discomfort for fear of additional pain
  • Participate in pre-hospital visit, when possible
  • Read books about visiting the hospital
  • Include the child in his or her care


School-Aged Children

Reactions:
  • Fear of pain; real or imagined
  • Fear of loss of control; fear of inability to return to doing what he or she was able to do before hospitalization
  • Fear of loss of respect; loss of respect of parents as being seen as weak or not as strong as one “should” be
  • Fear of loss of love; fear of loss of love due to causing a disruption in the family’s normal routine
  • Fear of anesthesia; fear that if he or she goes to sleep that they may not wake up/loss of control due to anesthesia
  • Fear of bodily injury, causing the child to question whether or not he or she will return to “normal” after the hospitalization
  • Stress over separation from school and friends
  • Concerns over loss of body privacy

What you can do:
  • Encourage communication between school and child, dependent upon child’s feelings and wants regarding friends’ knowing private information
  • Offer the child as much privacy as possible and as many choices as are reasonably available
  • Read books about hospital visits
  • Provide preparation on expected hospital experiences
  • Include the child in his or her care


Adolescents

Reactions:
  • Stress regarding separation from friends
  • Fear of loss of status among group of friends
  • Anxiety related to changes in physical appearance
  • Anxiety related to long term illness
  • Concern for privacy
  • Regression can occur during uncomfortable situations

What you can do:
  • Encourage communication between the adolescent and friends, dependent upon teen’s feelings
  • Provide accurate and honest information about their hospital experiences, this will help the teen to feel more comfortable knowing what to anticipate
  • Encourage teens to participate in their own care