In Reply We thank Ilhan and Hush for their valuable comments in response to our recent Research Letter on postoperative opioid expectations in pediatric patients and would like to address their concerns. While children are at risk of developing opioid dependence after prescription of perioperative opioids,1 the risk of underrecognition and undertreatment of pain in children must be taken into account. We agree with Ilhan and Hush that appropriate evaluation and management of perioperative pain in pediatric patients is vital. However, we do not believe that aiming for an opioid-free recovery after specific pediatric surgeries compromises this shared goal.