If your child needs surgery, you and she are probably both overwhelmed and frightened by this new situation. But if you have other children, it's important to remember that they, too, may be worried and upset. They hear and see things that they may not understand, and they're separated from their parents, their brother or sister and daily routines.

What brothers and sisters may be feeling

• Confusion: Siblings may not understand what is happening and why, especially if the hospitalization is sudden.
• Guilt: They may have had an argument with their brother or sister and think that they caused the hospitalization. They may also feel guilty because they aren't sick instead.
• Fear: Siblings may worry they'll "catch" what their brother or sister has, especially if they're not sure why he or she needs surgery in the first place. They may also be afraid their sibling won't get well and come home.
• Anger: Siblings may be angry at their brother or sister for getting sick. They may be angry that their parents didn't prevent the illness or injury.
• Jealousy: Brothers and sisters often feel jealous of all the attention the hospitalized sibling is receiving — including gifts and visits from relatives. Siblings who don't understand what's happening at the hospital often think that their brother or sister is there having nothing but fun.
• Rejection: Siblings may feel unimportant and left out of what's going on at the hospital.
• Loneliness: They miss having their parents around to comfort and care for them. They miss having their hospitalized sibling to play with.
• Worry: Brothers and sisters may wonder: "Who's going to take care of me? Who's going to be there to walk me home from school, help me with my homework, and fix my dinner?"

How brothers and sisters may express what they're feeling

• Changing their eating habits
• Acting out
• Clinging to parents
• Becoming withdrawn from family or friends
• Regressing to habits they had previously abandoned, such as bedwetting or thumb-sucking
• Saying they feel sick, too
• Playing aggressively with toys

How you can help your other children

• Fill them in. Let them know what will be going on (or is going on) at the hospital. Include them in conversations, when appropriate.
• Encourage discussion. Encourage them to talk about their feelings and concerns and to ask questions. If children don't know what's happening, they'll imagine something far worse than what's going on. Give young children simple answers and older children more information. Above all, be honest. Tell them it's OK to cry and be afraid.
• Reassure them. Let them know that even when you have to be at the hospital, another responsible adult whom they trust will be there to make sure they're taken care of.
• Keep your routine. Try to stick to a schedule — such as naps, meals and bedtimes — as much as possible. When you can't be there, make sure your child's caregiver does the same.
• Make private time for you and your well child. Getting special attention helps them to feel important.
• Communicate with caregivers. Tell your child's teacher or babysitter what's going on, so they can be aware and inform you of any changes in your child's behavior.
• Leave a security item. If you can't be with your child at home, ask her to hold a very special item of yours — something she specifically associates with you — until you return.
• Offer lots of extra love. In the time you do have with your well children, give them lots of compliments and hugs. Thank them for being patient and understanding.
• Read books with your child about going to the hospital.
• Visit their sibling in the hospital if appropriate.

How to help siblings staying at home feel connected

• Talk to their brother or sister on the phone
• Help pack some of their brother's or sister's favorite toys, books or games to go to the hospital
• Make a picture or greeting card to decorate the hospital room
• Exchange pictures with the patient. Siblings at home can choose pictures to be hung in the patient's room. Pictures of sibling in the hospital will help the child at home see where the patient is and what she's doing.