Seriously ill children and their parents can find themselves spending more time in a hospital ward than in their family home during the festive period.
But brave children battling life-threatening illness have smiles on their faces thanks to the team behind the biggest children's hospital in Northern Ireland. And those doctors and nurses who treat the young patients at the Children's Hospital in the Royal Victoria Hospital have, for many, become part of an extended family offering hope and support during the darkest and toughest of days.
Ahead of Christmas Day, the medical team swapped their normal scrubs and white coats for Santa hats and fancy dress to perform the annual staff pantomime. Play services co-ordinator at the hospital, Jacqueline Jamison, explained: "Even if it is an hour the staff will let as many children go home for that time as they possibly can because they don't want the children to be here at Christmas. But for those who are too sick and can't go home, the hospital is a lovely place at Christmas just because the wards do pull out all the stops.
"The staff are working too and they will try and make it as merry for the families as possible."
And one of the annual highlights for the children is the pantomime, written by the junior medical team and involving all levels of medical staff.
Laughs, smiles and singing echoed throughout the foyer of the busy hospital. Among the audience was nine-year-old Noah McGlade from Belfast, who was brought into hospital after suffering a bad asthma attack.
"He has had asthma since he was a baby so he has been in and out of hospital," his mum Clare said.
"He has had a good few years, but this was the first attack in two years."
She said having a child in hospital can be tough on family life.
"I haven't been home," she added.
"This is the first time we have been up in hospital around Christmas time but the staff are fantastic; you couldn't ask for a better bunch of people. I hope that we will be home for Christmas - fingers crossed."
She added: "He has four sisters and a brother but he hasn't got to see them because they are not really allowed in in case of infection. It is tough going, but you all just pull together - I've my mum and my partner, Gerard."
James Clenaghan from Lurgan was also enjoying the performance with his four-year-old son George.
"He had his appendix out - it was a bit of an emergency," he said.
"He has been here over a week, but we are hoping to get home for Christmas. The staff have been lovely. They relate so well to the patient and they put the children at ease. They know how to talk to the children."
When asked what he looked forward to the most at Christmas, George said: "I miss my big sister Rebecca. I'm just looking forward to seeing her."
Ten-year-old John-Joe Toner was also in the panto audience.
His father Cormac from Armagh said: "He has been here for three or four days. He has an irregular heartbeat.
"He will only be in for another day or so, so we hope to get home for Christmas.
"The staff have just been fantastic. Having something like the panto just breaks up the day for them."
Ailish McAtamney (35), a full-time mum, was with her eight-year-old daughter Megan having her annual check up.
"We are day patients and have been attending the Royal for eight years as Megan has a lung disease. We always seem to have an appointment around this time of year," she said.
"It helps you see the other side of the doctors. A lot of the time they have to be serious because of their job, but the panto lets you see the jokey, fun side. It is such a hard job that they do."
Among the performers was Majella McCullough, a paediatric surgeon, who donned a Santa hat to take to the stage.
"I've been doing these pantos for 20 years now -10 here and 10 in London. I think from a staff point of view it is a great morale booster. The script was written the day before at 11am. Everybody mucks in at the very last minute and it creates great team spirit. The rest of the departments like laughing at us. We just really enjoy it."
Dr David Colvin (28), a surgeon from Armagh, described the atmosphere within the Children's Hospital as a special one.
"I've been here for four months at the children's hospital," he said. "It's great as these children spend so much time on the wards and maybe only see their family members and other children once a week. They don't have that much interaction with their other brothers or sisters or friends."
"It is great for the hospital too. There is a real family feel to this hospital - you work as part of a team in any hospital or children's hospital, but here everyone has that family feeling about them."
Jacqueline Jamison, who has been a play specialist for 23 years, is one of a team of 14 which works to ensure the children have time to play and feel like 'normal' boys and girls during what can be an incredibly tough time in their lives.
"The Christmas programme has been ongoing here for years," she said. "It is a huge part of what goes on in the hospital. It means we can bring Christmas into the hospital as a lot of the children here are unable to get home. Every year there are lots of things going on.
She added: "To be perfectly honest, it isn't just for the children, it is for their parents as well, because we focus all our attention on the children and you forget about the family.
"We shouldn't forget it is also uplifting for a lot of the staff, because they go through a lot of hard times on the wards too. They get attached to a lot of the children and it lifts their spirits to be able to come down and join in."
Ms Jamison said that the events throughout the festive calendar puts smiles on all faces.