Don’t knock out your toddler

Your child tripped on the back steps and has ended up with a long deep gash on their leg. You head to the ER to get it stitched up. Turns out your toddler has other plans and wails and thrashes around whenever the doctors try to take a look. In many ERs around the country the doctor will recommend sedating your child to prevent the trauma your child is experiencing as well as the anguish you must be feeling watching your child suffer.

For the last ten years, evidence has been building that giving young children anesthesia can be bad for their developing nervous system. The evidence in juvenile rodents is extremely compelling while studies in humans show a trend but some variability. Links have been shown between anesthesia before 4 years of age and increased rates of ADHD and cognitive dysfunction. While there are many cases that require surgery before the age of 4, there are often elective surgeries that would be better postponed.

A new study in the Journal Pediatrics, shows that after adjustments for demographics, there is a significant increased risk of language related disability correlated with anesthesia exposure under the age of 4. Specifically, the children showed deficits in listening to and remembering spoken words. This particular study is striking because the neuropsychological outcomes were based on a battery of direct testing measures rather than standardized testing or parent reporting.

While there are often confounding factors, including the reasons for why these children need anesthesia and surgery so young, there is still strong evidence that anesthesia at an early age can be detrimental to the development of children’s brains.