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In the context of the medical and hospital care of children, consent raises ethical issues and practical difficulties, related to legal ambiguities, to current representations of children in our societies, to tensions between individual and clinical rhythms, or to the resistances displayed by children during daily care gestures. As part of a research focused on the experience of Beninese and Togolese children suffering from congenital heart defects and cared for by a humanitarian medicine program in Switzerland, this article aims to highlight the silent, discreet, gradual and collective forms of consent that often go unnoticed in discourses and ethical debates surrounding the concept of consent. Based on ethnographic observations in various general pediatric departments and pediatric cardiology units, the article explores how health staff and children negotiate and agree on the modalities of carrying out examinations and care. By paying attention to consent in the making, this article proposes an alternative conception of consent which integrates material and human mediations as well as the notion of micro-consent, resulting in a sequence of discreet and gradual agreements involving verbal, bodily, material, and temporal registers in routine situations. The data documents the important positioning, bodily, emotional and mediation work that is carried out by children and health staff in uncommon care situations due to the absence of a parental third party.