Before Your Child’s Surgery

Important: stop eating and drinking before anesthesia or sedation

The rules about eating and drinking before an operation are very important. Any food or liquid in your child's stomach while going to sleep under anesthesia can flow up to the mouth and pass down into the lungs. This is very dangerous for your child.

If these rules are not followed your child's procedure will be cancelled. Please read them carefully.

• At midnight (12 a.m.) before operation time:
  • Stop solid foods
  • Solid foods include liquids with solid components/bits (i.e. orange juice, soup broth) as well as jello
  • Patients who no longer drink from a bottle should not have solids or any time of milk after midnight
  • No gum or candy after midnight
• 6 hours before operation time:
  • Stop bottle feeds/tube feeds
    
• 4 hours before operation time:
  • Stop breast milk
    
• 3 hours before operation time:
  • Stop clear fluids
  • Clear fluids are fluids you can see clearly through (i.e. water, clear apple juice, ginger ale)
  • Jello is not a clear fluid

It is important that your child does not have any other illnesses that will make it harder for them to recover from their surgery. A fever, cold, cough, runny nose, or sore throat can become much worse after an anesthetic, or make it harder for your child to breathe during or after the procedure.

Does your child have any of the health issues listed below?

• Recent asthma flare
• Fever, cold, cough, runny nose or sore throat
• Recent viral infection including COVID-19, flu, pneumonia and RSV.

If your child has any of these above listed symptoms please call your surgeon's office. The surgeon will decide if it is safe for your child to proceed.

For instructions to SickKids by car or public transit, review Map & Directions. For places to park around the hospital, please see Parking Information. 

There is ongoing construction in the Atrium Parking Garage. To plan ahead of your visit, please check for parking updates.

Leave yourself lots of time to get to SickKids  so you arrive two hours before the scheduled surgery time.

For those staying overnight and looking for places to stay close to SickKids, please visit Staying Overnight. 

• Bring all medications and herbal remedies that your child is currently taking in original containers. This includes: pills, inhalers, puffers, injections, eye drops, vitamins, etc.
• Bring your child’s Ontario health card
• Bring contact information of your family doctor and/or paediatrician, as well as any specialists
• Bring any medical supplies that your child requires daily (i.e. feeding tube attachments, mobility devices).

At SickKids we do our best to prevent infections after surgery. You play an important role in reducing your child’s risk of infection by ensuring they have been bathed properly before their surgery.

Because skin is not sterile, there are steps that need to be taken to make sure your child’s skin is as free of germs as possible before surgery. You can reduce the number of germs on the skin by carefully bathing them before surgery using the instructions below. Please report any rashes, infections, open areas or sores on your child’s skin to their surgeon before the scheduled surgery date for any further instructions.

Important: Your child will need to bathe with liquid soap. The soap needs to be in liquid form to prevent cross contamination that occurs with bar soap. The brand of soap does not matter.

Younger children should be bathed by a parent or guardian; older children should be supervised to make sure that washing is done effectively.

Patients coming for surgery should remove all nail polish and jewelry including piercings and not wear any makeup or apply lotion on the day of surgery.

Review Preoperative Patient Bathing (PDF) for full instructions.

We do not recommend bringing any other children to the hospital with you on the day of surgery. If possible, we recommend alternative arrangements for siblings. Siblings are not permitted to visit patients in the recovery room, nor the intensive care unit, or some other areas of the hospital where patients require very specific care.

Learn about guidelines for Visiting a Patient.

Whether your child is staying overnight or just for the day will determine what you pack for your stay at SickKids.

Packing for day surgery (you will go home the same day)

This means your child will not be admitted to the hospital overnight. If your doctor has told you that your child will be coming for a day procedure, we suggest bringing the following items from home.

For your child

• A loose-fitting, comfortable outfit that will fit over any applications (such as a cast) that your child may have after the surgery. Also, make sure it's easy to put on and won’t rub against the area of their surgery.
• A security object that your child may want to bring into the surgery with them. We suggest limiting this to one or two items (stuffed animal, blanket, favourite toy, etc.)
• An empty bottle or sippy-cup for your child to drink clear fluids from after the surgery (for younger children)
• A plastic bag or plastic container that you can use if your child feels sick on the way home
• Eyeglasses and case, or retainer and case, if your child wears them.

For yourself

• A pen and paper to write down the surgeon’s recommendations for care of your child at home
• A book, magazine, crossword, or other material for yourself during your child’s surgery
• Snacks for yourself. It is important to remember to eat throughout the day. Feeling weak or lightheaded will interfere with your ability to care for your child.

Same day admit (you will stay overnight at the hospital after surgery)

This means your child will be admitted to the hospital overnight on the same day of their surgery. They will go to a unit after their surgery and stay overnight. Your child will be provided with pajamas, slippers, a pillow and bed linens. One parent will also be provided with a pillow and blankets. We suggest the following items from home.

For your child

• A security object that your child may want to bring into the surgery with them, we suggest limiting this to one or two items (stuffed animal, blanket, favourite toy, etc.)
• An empty bottle or sippy-cup for your child to drink clear fluids from after the surgery (for younger children)
• An extra pair of pajamas for your child to wear a day or so after the surgery. If they will be staying more than one night, children sometimes feel better wearing their own clothing
• Toiletries, such as toothbrush, toothpaste, and hairbrush for both you and your child
• Reading material or a favourite low-key entertainment options (card games, board games) for your child to do while recovering on the unit

For yourself

• A book, magazine, crossword, or other material to occupy yourself during your child’s surgery
• Snacks for yourself, it is important to remember to eat throughout the day
• Phone number of family and friends whom you would like to contact

Children with asthma are at higher risk for bad reactions, like breathing problems, either during or after surgery. If your child has asthma, you can help reduce the risk by making sure their asthma is well managed before the procedure or operation.

Children with asthma may have symptoms like:

• Wheezing
• Coughing
• Tightness in the chest
• Shortness of breath
• Sensitivity to irritants like cold air, common allergens and second-hand smoke

If your child has asthma and often has these symptoms, please book an appointment with your family doctor or paediatrician to try to get them under control well before their procedure or operation. A change in medicine or a visit to a specialist may be needed. Please book this appointment at least six weeks in advance of the surgery, procedure or test.

Asthma medication on the day of surgery

It is very important that you bring your child’s puffer or other medicine to treat symptoms, on the day of surgery.

Your child should take any prescribed asthma medicines (such as Flovent) as usual on the morning of surgery. Your child may be asked to take this medicine, even when not having symptoms on the day of the procedure and possibly in the days before as well.

Children with breathing, heart or other serious medical issues need special care when given anesthesia for a procedure or operation.

If your child has a chronic (ongoing) or complex medical problem, you must tell your anesthesiologist about their normal health routines and conditions. You need to work with your anesthesiologist to make a care plan that is best for your child. If your child has a specialist, the anesthesiologist may require documentation or need to communicate with them in order to determine the best way to support them during and after the surgery.

Herbal medicines and supplements may be a big part of your child’s usual health routine. However, some herbal medicines that are normally safe can cause problems if your child is having a procedure or operation under anesthesia.

Herbal medicines can be unsafe for children under anesthesia because they:

• Are not regulated, and your doctor will not know exactly what is in the medicine
• May increase your child’s risk of bleeding
• Make anesthesia last longer
• May cause low or high blood pressure
• Can cause many other side-effects and complications

It is important to discuss all herbal medications your child is taking during your pre-anesthesia assessment.