The following reactions are common in children post-hospitalization and should diminish over time. If these reactions persist or you have any concerns, you should talk to your child’s pediatrician.
Infants (0-12 months)
Common Reactions
- Infants struggle due to the changes in their daily schedule.
- Older infants (6+months) may be more clingy, have sleep disruptions or exhibit fear of strangers. They may also exhibit new fears at their next doctors office visit (not wanting to sit on the exam table etc.)
How to Help
- Infants feel safest in their routine so it is important to try to get them back on their schedule as soon as possible.
- Bring your child’s favorite comfort toy to his or her next doctor’s visit. Allow your child to sit on your lap during the doctor exam.
Toddlers (1 year-2 years)
Common Reactions
- Regression is common in toddlers post hospitalization. Toddlers who slept through the night may wake up more often and toddlers may also become more clingy.
- Toddlers may also exhibit strong fears at the doctor’s office.
How to Help
- Medical play with your child (i.e. using a play medical kit, using dolls, toy animals etc.) will help your child work through some of his or her hospital experiences.
- Older toddlers may also benefit from story books about the hospital.
- Getting back into your schedule/routine is very important for toddlers too.
Preschoolers (3 years-5 years)
Common Reactions
- Regression is common in this age group also. Children who were potty trained may have a few accidents, children who were not using a pacifier/sucking their thumb anymore may start doing this again. The child who loved preschool may start crying when it is time to leave his parents at school.
- Misconceptions are common. Preschool children have magical thinking and they may believe they caused their illness or they may believe hospitalization was a punishment for something they did “wrong.”
- The perceptions a preschool child may have of what happened during the hospital stay may be very different then what really happened. (A child who had an x-ray, for example, may remember this huge machine that he was worried would crush him, rather then a camera that just took his picture.)
How to Help
- Medical play is an important way for preschoolers to play through their experience and it gives you a chance to clear up misconceptions your child may have about his/her hospitalization and the different tests your child may have underwent.
- Asking a preschooler questions about his/her hospitalization (i.e. “Why did you have to go to the hospital? What was your favorite part of the hospital? What didn’t you like about the hospital?”) will give you insight into your child’s perceptions of his/her hospitalization.
- Reading books about the hospital together brings up many opportunities to talk about your child’s recent hospitalization.
- When a preschooler is showing signs of regression post hospitalization it is important not to reprimand him/her for the behavior and instead reassure him/her that he/she is brave, doing a good job etc.
- If a preschooler is having difficulty separating from you at school it is important that the teachers are made aware of the recent hospitalization so they can help with this transition. Teachers can also be more aware of your child’s play at school and help to identify any misconceptions your child may be demonstrating in his/her play. It is also important to reassure your child that they are safe and that you will be back at the appointed time and then to show up at that appointed time.
School-Agers (6 years-12 years)
Common Reactions
- School-aged children may also show signs of regression (wanting to sleep in parent’s bed).
- This age group may also experience nightmares.
- School age children are beginning to be concerned with how they look and what people will think about the way they look.
- This age group may have difficulty transitioning back to school after a hospitalization and worry about all they missed while they were out of school.
How to Help
- Talking about the hospital experience often helps. Books about hospitals are a good conversation starter.
- If your school-aged child does not want to talk about the experience he/she may want to use artwork to express his/her feelings post hospitalization.
- If your child is exhibiting new behaviors post-hospitalization, you may want to let your child’s teachers know about the hospitalization so the teacher can monitor your child for behavior changes in school.
- Your child’s teacher and school counselor can also help with your child’s transition back to school and can create a plan to help your child make up what was missed.
- School counselors can help by talking to your child’s class about physical changes your child may have or limitations in activity post hospitalization. Sometimes children would like to participate in this classroom conversation and sometimes children would prefer the teaching be done before they return. It is important to ask your child what he/she would prefer.
Teenagers (13 years-19 years)
Common Reactions
- Teenagers often have body image issues and can suffer from decreased self esteem post-hospitalization.
- Teenagers often worry about catching up on missed school work and activities.
- This age group also worries about what their peers’ reaction will be and often do not want special attention, especially at school, because they just want to “fit in.”
How to Help
- Support groups work well for many teens because they find peers who understand what they are going through. If there is not a support group for your teen’s condition, the internet can be a great tool for teens to find peers to talk to about what they are going through.
- The teenager’s school counselor can be a great resource to help teens reintegrate into school.
- Offering teens opportunities to utilize art, music and writing can help them to express their emotions.
- Teenagers should also be invited to participate in discussions around their condition and future treatment decisions.
Written by Hillary Gannon, CCLS, 2008; reviewed by Patricia O’Malley, MD, 2008
