There is no paediatric anaesthesia qualification in South Africa, but all my anaesthetists work primarily with children and have vast experience in the field. I never work with an anaesthetist who only sometimes does paediatrics.

www.southernanaesthetics.co.za

The key to preparing your child for their operation is to tailor your explanations and activities to your child’s age and level of understanding. You know your child best, so you will be able to gauge what they will be able to understand and when.

Here are a few pointers we give to parents beforehand:

• Talk to your child about coming to hospital using simple, easy-to-understand language.
• Giving too much information can also be frightening, especially to young children.
• Encourage your child to ask questions and ask them yourself. With older children, making a list of questions before an appointment or admission can help address any fears or worries.
• Most importantly, let your child know it is okay to feel scared or upset. These are perfectly normal feelings and nothing to worry about or be embarrassed by. Tell them it’s alright to let you know if they’re worried or in pain.

• Solid food and formula milk – 6 hours pre-op
• Breast milk – 4 hours pre-op
• Clear sweet liquids – 2 hours pre-op.

This can be black tea with sugar, apple juice, grape juice etc. If you can read the newspaper through the juice, your child can have it. Please check with us if you are unsure and confirm the amount of juice your child is allowed to have.

NB – Please be aware that if you do not adhere to the feeding guidelines, your child’s operation will be deferred or cancelled entirely. We must ensure the safety of your child at all times.

Unfortunately, surgical operations require hungry tummies. This can be very distressing for both parents and children, but it is vital to adhere to the feeding guidelines before entering the theatre.

When your child is anaesthetised, their body, including the stomach and reflexes, relax. So any food or fluid in your child’s stomach will flow up the food pipe and down into the lungs and drown them. We must be strict about this, even though your child might cry for food.

We understand that this is distressing, and we try our best to arrange the operating times list in such a way that the smallest children are operated on first. Everyone gets fed as close to operating time as possible, but life happens, and this may not always go according to plan.

We want your child to be as comfortable as possible in the theatre, so they may come dressed in whatever they prefer. We will dress them in hospital clothes when they are asleep. They may also bring a favourite toy or blanket into the theatre.

For children older than 6 months, one parent or guardian may accompany them into theatre and stay until they are asleep. For children younger than this, the benefit of parental presence is not as significant.

If it is an emergency operation, you may not be allowed to come into the theatre with your child. Our priority, as always, is the safety of your child. We usually use a mask and gas to put your child under anaesthetic. If a drip is required, we insert this after your child is asleep.

Most small procedures are day cases. This means that you will bring your child to the hospital on the day of the operation, and they will be discharged on the same day. We advise bringing your little one some toiletries and a change of clothes just in case they are required to stay overnight. You will be supplied with written post-op instructions and a follow-up appointment date.

• Abscesses
• Appendicitis
• Buried penis
• Cancer surgery, including insertion of chemo ports, biopsies and tumour excision
• Circumcision for medical or religious reasons (Please note that circumcision performed on children under the age of 16, for any other reason, is a prosecutable offence as per section 12 of the children’s act 2008)
• Congenital abnormalities (congenital disabilities), e.g. Diaphragmatic hernia, Intestinal atresia, Gastroschisis, Omphalocele, Oesophageal atresia, Anorectal malformations
• Disorders of sexual differentiation
• Gastrostomy insertion/PEG
• Hirschsprung’s disease
• Inguinal hernias and hydroceles
• Insertion of dialysis devices
• Intestinal polyps
• Intussusceptions
• Keyhole surgery
• Liver and bile duct problems, e.g. Biliary atresia, Choledochal cysts
• Lumps and bumps
• Malrotation and volvulus
• Neck cysts and sinuses
• Necrotising enterocolitis
• Paediatric Gynaecology
• Pyloric stenosis
• Removal of swallowed or inhaled foreign bodies
• Trauma
• Umbilical and epigastric hernias
• Undescended testicles
• Vascular tumours and malformations

NB – I do not treat burns, bone disorders, heart abnormalities or brain disorders. My particular interest is neonatal surgery.

My practice is centred on your child’s comfort, so no painful procedures are carried out in the rooms. Please don’t tell your children to “behave or the doctor will give them an injection!” I don’t have any needles and my interaction with your child becomes impossible if they are afraid of me.