Tell them later than you think, and say it in five sentences
Grommets, tonsils, a tooth under anaesthetic, a scan that needs them still. The whole plan is on this page, free. It does not replace the letter from your hospital, and the letter wins every time the two disagree.
- 1Work out when to tell them
Not as soon as you know. Roughly the day before for a pre-schooler, a few days at five or six, a week or more from eight. This is the step everyone gets wrong and it is the one with a source.
- 2Five sentences, not a conversation
What is being fixed, that there is a special sleep, that you will be there when they wake, that you are going home the same day, and that they can ask you anything. Then stop talking.
- 3One thing to practise
The mask. Cup your hand over your own nose and mouth, breathe out slowly and count to five, then let them do it to you. Thirty seconds, twice. It is the moment children describe afterwards.
- 4One sentence for you, in the anaesthetic room
Because that is the moment parents describe as the worst. “I am right here. Take a big breath of the funny air, and I will see you when you wake up.”
- 5Ring the ward and ask for the play specialist
An NHS role whose published job is to prepare children for treatment. Most parents have never heard of them. One phone call.
Every hospital leaflet tells you what will happen. Almost none of them tells you what to say, and that is the part you need at seven in the morning with a child who has not eaten.
Later is kinder, and this is the part nobody believes
The instinct is that a bigger event deserves more warning. For a small child it does the opposite. NHS guidance for parents is unusually specific about it: pre-school children probably only need to know the day before, while older children need more time for the information to sink in. A four-year-old told a fortnight early does not spend that fortnight preparing. They spend thirteen extra nights afraid, and arrive tired.
Rough shape, and you know your child better than any rule: three and four, the day before. Five and six, two or three days. Seven and up, a week, because by then they will hear it from somewhere else and it should be from you. If they ask a direct question before that, answer it honestly - the rule is about when you raise it, never about denying it.
The five sentences
Say them once, in this order, somewhere ordinary. Not at bedtime, which hands them the thought and then the dark.
“On Thursday we are going to the hospital so the doctors can fix your ear.” Name the day and the part. Vagueness is what a child fills in, and what they fill in is worse.
“They will give you a special sleep so you do not feel anything while they do it.” Not “you will go to sleep” on its own, which gets tangled with bedtime and with pets that were put to sleep. The word to use is the one the hospital uses.
“I will be there when you fall asleep and I will be there when you wake up.” Check this is true before you say it - ask the ward whether a parent comes into the anaesthetic room and who collects them in recovery. A promise you have verified is worth ten reassurances you have not.
“Then we come home, the same day, and you can have ice lollies.” The ending is the part they will repeat back to you all week.
“You can ask me anything about it, any time.” Then stop. The most common mistake after a good explanation is a second one an hour later.
What not to promise: that it will not hurt. It is the only sentence here you cannot guarantee and the one they will hold you to. Say instead that they will not feel the operation, that something might be sore afterwards, and that the nurses have medicine for exactly that and you will ask for it.
The mask, practised twice
Where an anaesthetic starts with gas, a soft mask is held near the face and the child breathes it in. Children describe that moment afterwards more than any other part of the day, and it is over in seconds - which is exactly the shape of thing a rehearsal helps.
Cup your hand over your own nose and mouth. Breathe out slowly and count to five out loud. Then let them do it to you, then do it once themselves. Thirty seconds, twice, on two different days. Make it silly. The silliness is not decoration, it is what makes a child willing to do it a second time.
Some anaesthetics start with an injection into a vein instead, and the anaesthetist will ask you and your child whether you have a preference. Ask which is planned when you arrive, so the thing you practised is the thing that happens.
What only your letter can tell you, and it is the part that matters most
When your child must stop eating and drinking is on your hospital’s own letter, and it is the one instruction on the whole day to follow exactly, to the minute. The times differ by hospital, by age and by what is being done, which is why no website should hand you numbers - including this one.
Why it matters, in an NHS trust’s own words: if there is food or liquid in the stomach during an anaesthetic, it “could come up into the back of the throat and damage his or her lungs”. A child who has eaten is normally sent home without the operation, which is a wasted day and a second round of dread.
Also on the letter and not here: what time to arrive, what to bring, and who to ring if your child develops a cough, a cold or a stomach upset in the days before, which can be a reason to postpone. Ring them. They would far rather hear from you than see you.
Ask for the play specialist. Most parents never do.
There is a person at the hospital whose actual job is this. A health play specialist is registered NHS staff, and the role’s own published description says they use play as a therapeutic tool to help children understand their treatment and to “prepare children for treatment and engage them during difficult procedures”. Some trusts describe it as preparation, distraction and post-procedural play.
Ring the children’s ward and ask two things: whether a play specialist can see your child before the day, and whether you can visit the ward beforehand. Both are commonly offered and rarely volunteered. This is the highest-value item on this page and it costs a phone call.
If the appointment coming up is a check-up rather than an operation, the same spine works on a much smaller scale, and it is written out separately. Take a look
Sources
- Moorfields Eye Hospital NHS Foundation Trust – Your child’s general anaesthetic (when to tell a child, by age; why the fasting instruction matters; play staff on the ward)
- NHS Health Careers – Health play staff (the registered role, and its published description of preparing children for treatment)
- NHS – General anaesthetic
Common questions
When should I tell my child about the operation?
Later than instinct says, and the NHS guidance is specific: pre-school children probably only need to know the day before, while older children need more time for it to sink in. For a four-year-old a fortnight of notice is not preparation, it is thirteen extra nights of dread. The rule is roughly a day for a pre-schooler, a few days at five or six, a week or more from about eight.
What do I actually say?
Short, true, and in their words rather than the letter’s. "The doctors are going to fix your ear. You will have a special sleep so you do not feel it, and when you wake up I will be there and we will go home." Every hospital leaflet explains what happens; almost none of them gives you the sentence, which is the part parents actually need at seven in the morning.
Should I promise it will not hurt?
No. It is the one promise you cannot keep and the one a child will hold you to for years. Say what is true instead: that they will not feel the operation, that afterwards something might be sore, and that the nurses have medicine for exactly that and you will ask for it.
What about eating and drinking before?
Your hospital’s own letter, exactly, to the minute. The times differ by hospital, by age and by procedure, so no website should be giving you numbers - including this one. It matters more than anything else on the day: as one NHS trust puts it, food or liquid in the stomach during an anaesthetic "could come up into the back of the throat and damage his or her lungs", and a child who has eaten is usually sent home unoperated.
Can I be with them when they go to sleep?
Usually one parent can come into the anaesthetic room, and it is worth asking when you arrive rather than assuming either way. Ask the same question about who collects them in recovery. Knowing the answer the night before is what lets you tell your child something true about it.
Is there someone at the hospital whose job this is?
Yes, and most parents have never heard of them. Health play specialists are registered NHS staff who, in the words of the role’s own published description, use play to "prepare children for treatment and engage them during difficult procedures". Ring the children’s ward and ask whether one can see your child before the day. It costs a phone call and it is the single best thing on this page.
All three sources were read on 22 September 2026. Nothing here is medical advice and none of it replaces the letter from your hospital or the team looking after your child - where this page and your letter disagree, your letter is right. We give no fasting times, no arrival times and no description of any procedure on purpose: those differ by hospital, by age and by operation. We name these organisations to identify their published guidance and imply no affiliation with any of them. If a line here stops matching its source, tell us and we will correct it.
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