Helping Children Cope With Grief When An Infant Dies
Introduction
Our lives consist of beginnings and endings.
Many of them we share with our children: the beginning of a
summer vacation and returning home, sunrise followed by sunset.
Because death is the ending of life, this too must be shared
with our children if they are going to have a chance to mature
normally and see the world for what it is. Unpleasant as it
is to think about, as hard as it is to apply to those we love,
and as much as we would like to believe otherwise, all of us
are mortal (Fitzgerald, 1992). We can provide our children
with an explanation to help them understand the death and how
to cope with the loss.
Explaining the death of an infant sibling
or loved one can be a very difficult, sensitive, and painful
process, especially when parents are also grieving. Because
some adults have problems dealing with the reality of death
themselves, they may have difficulty explaining the death to
a child. Children grieve the death and react to the emotions
in the household. Children also need reassurance that they
are not the cause of these intense emotions. The best approach
is to be truthful and explain what is known about the cause
of death.
“If a child is old enough
to love, He or she is old enough to grieve.â€
(Goldman, 1994)
“If there is no discussion or attempt to explain the death,
children often imagine the worst, including that they did something to cause
it. It’s terribly scary and unsettling to lose the family
unit as it has been known. But, handled openly, the death can actually open
a door for families to grow together in a positive direction.â€
(Fitzgerald, 1992)
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Sudden Unexpected Infant Death
When a baby dies suddenly, there is a great
sadness, and every family member experiences the death and
walks the path toward grief recovery in a unique way. Children
who are too young for complete explanations need love from
their parents to feel secure. Some young children may be frightened
about sudden, unexpected death. They may cling to parents and
misbehave to get attention. Others feel responsible about the
death and need reassurance that sudden infant death syndrome
(SIDS) is a serious medical problem that occurs suddenly and
unexpectedly (Shaw 1994). If the baby’s
death is due to SIDS, children need reassurance that this happens
to infants and will not happen to them.
| Birth to 3
years |
Affected most by the mood of their
caretaker.
You may see changes in sleeping and eating patterns, mood.
Older infants and toddlers may demand more attention. |
Maintain routines and familiar places.
Provide abundant love, attention and reassurance.
Provide a caring substitute if parent is too distraught
to respond. |
| 3 to 6 years |
Does not understand that death is permanent.
Fears the dead person is cold or hungry.
Repeats questions and fears that others and/or self will
die. Afraid to go to sleep, may have bad dreams.
May play-act events around the death.
May revert to earlier behaviors and/or physical symptoms. |
Maintain routine; provide lots of affection
and attention.
Repeat answers as often as child asks.
Look into child’s eyes, gently hold
them when speaking of death.
Allow expression of feelings--re-enacting events, drawing,
reading.
Avoid words like sleeping, resting, lost, passed away,
God took him.
Use concrete terms like the baby died, Ryan doesn’t
eat or grow. |
| 6 to 9 years |
Views death as mysterious--takes baby
away or caught like a cold.
Some still think death is not permanent.
May be obsessed with cause of death, what happens to the
body.
May feel responsible due to past actions, words, wishing
sibling dead.
May be distressed, sad, or show no signs.
Fears loss or abandonment by family members. |
Maintain routine.
If leaving, tell child when you will return and how to
reach you.
Listen to child express thoughts and feelings; provide
a journal.
Answer questions honestly.
Reassure that the death was not child’s
fault.
Contact child’s teachers. |
| 9 to 12 years |
Understands that death is permanent.
May seem unaffected by death.
May see the death as punishment for bad deeds.
May show anger, guilt, grief.
Physical symptoms are common. |
Provide lots of time and affection.
Encourage child to express feelings.
Reassure that death was not child’s
fault.
Be honest about what you are feeling.
Contact child’s teachers. |
| Teens |
May feel confused, sad, guilt, angry, lonely, afraid.
May experience physical symptoms.
May try to hide feelings to protect parents.
May assume responsibilities for family well-being. |
Be honest about your feelings.
Allow the teen time alone and to grieve in their own way.
Discourage teen from assuming too much responsibility. |
Adapted from The California Department of Health
Services. Maternal, Child, and Adolescent Health Branch. The
California SIDS Program. A Practical Guide to the SIDS Home
Visit, pp 2-20, 2-21.
“Sudden Infant Death Syndrome (SIDS) is the sudden death
of an infant under 1 year of age which remains unexplained after a thorough
case investigation, including performance of a complete autopsy, examination
of the death scene, and review of the clinical history.â€
Willinger et al., 1991
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Seeking Support Services
Each child will react to the death of an
infant in a very different way. Parents and caregivers should
keep in close touch with the child’s health
care provider in the months after the infant’s
death for questions and/or concerns about how the child is
coping. Mental health professionals can also provide support
to parents and children. Additional resources for families
include hospice organizations, local health departments, bereavement
support programs, and community or religious leaders or healers.
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Funerals and Family Rituals
Allow children to be included, if they wish
to participate, in family mourning rituals such as funerals,
memorial services, wakes, or shivas, as appropriate for the
family’s culture. Rituals are part of life
and a source of help in gaining comfort and building memories
of the infant who died. It is important to explain to children
beforehand what will take place during the ritual and that
those attending may be sad, may cry, or otherwise be emotional.
Younger children should have a trusted person with them, as
parents may have difficulty being supportive. It is important
to help children understand that these rituals provide the
grieving family and friends a time, place, and occasion to
cherish and remember the infant who died, and a way to say
goodbye.
“As difficult as it may be,
children need to participate in the rituals surrounding death—the
viewing, wake, funeral, and burial—to acknowledge
that the person has really died and to start the mourning process.
These rituals provide special times and places to remember
and honor the baby and to begin the natural quest for the meaning
of the death.â€
Joni Nelson Horchler & Robin Rice Morris
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References
Fitzgerald, H. The Grieving Child: A Parent’s
Guide. New York: Simon & Schuster, 1992.
Goldman, L. Life & Loss: A Guide to Helping
Grieving Children. Muncie, IN: Accelerated Development, Inc.,
1994.
Horchler, J. The SIDS and Infant Death Survival
Guide: Information & Comfort for Grieving Family & Friends & Professionals
Who Seek to Help Them. Hyattsville, MD: SIDS Educational Services,
2003.
Johnson, S.E. After a Child Dies: Counseling
Bereaved Families. New York: Springer, 1987.
Shaw, E. What To Do What A Loved One Dies.
Irvine, CA: Dickens Press, 1994.
Willinger, M., James, L.S., and Catz, C. “Defining
Sudden Infant Death Syndrome (SIDS): Deliberation of an Expert
Panel Convened by the National Institute of Child Health and
Human Development.†Pediatric Pathology September-October
1991; 11(5): 677-84.
Wolfelt, A. Understanding Grief: Helping
Yourself Heal. Muncie, IN: Accelerated Development, 1992.
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Selected Organizations that Provide Support and Services
The Dougy Center National Center for Grieving
Children, P.O. Box 86852, Portland, OR 97286. (503) 775-5683, help@dougy.org (e-mail), http://www.dougy.org
KIDSAID (Internet) This is an extension of
GriefNet, a comprehensive Internet community that has provided
support to over 3 million people in the last year. This is
a safe place for kids to ask questions and obtain information.
Visit http://www.griefnet.org or http://kidsaid.com .
Raindrop. A cartoon story that explains death
to children. http://www.iul.com/raindrop
The Waterbug Story. A brief, beautifully
written story on death—for all ages. http://www.healingheart.net/waterbug_story3.htm
Resources to Help Children Cope with
Loss
Brown LK, Brown M. When Dinosaurs Die: A Guide to Understanding
Death. North Dartmouth, MA: Baker Books, 1998. Available
from Baker Books, 96 State Road, North Dartmouth, MA 02747.
(800) 339-6705 (toll-free), (508) 997-6700.
Durant A, Gliori D. Always and Forever. San
Diego, CA: Harcourt Children’s Books, 2004.
Available from Harcourt Children’s Books,
15 East 26th Street, 15th Floor, New York, NY 10010. (212)
592-1000.
Gryte M. No New Baby: For Siblings Who
Have a Brother or Sister Die before Birth. Omaha, NE:
Centering Corporation, 1988. Available from Centering Corporation,
7230 Maple Street, Omaha, NE 68134. (402) 553-1200.
Johnson J, Johnson M. Where’s
Jess? (Revised Edition). St. Paul, MN: A Place to Remember,
2003. Available from A Place to Remember, 1885 University
Avenue West, Suite 110, St. Paul, MN 55104. (800) 631-0973
(toll-free), (651) 645-7045.
Mundy M, Alley AW. Sad Isn’t
Bad: A Good-Grief Guidebook for Kids Dealing with Loss. St.
Meinrad, IN: Abbey Press, 1998. Available from Abbey Press,
One Hill Dr., St. Meinrad, IN 47577. (888) 374-4226 (toll-free).
Old WC. Stacy Had a Little Sister. Morton
Grove, IL: Albert Whitman & Company, 1996. Available from
6340 Oakton Street, Morton Grove, IL 60053-2723. (800) 581-0033
(toll-free).
Roper J, Grimm L. Dancing on the Moon. Hyattsville,
MD: SIDS Educational Services, Inc., 2001. Available from SIDS
Educational Services, Inc., PO Box 2426, Hyattsville, MD 20784.
(877) 935-6839 (toll-free), (301) 322-2620.
Sanders DB, Ed. Helping Children Grieve:
Sudden Infant Death Syndrome. Rancho Cordova, CA: California
SIDS Program, Maternal and Child Health Bureau, California
Department of Health Services, 2001. Available from California
SIDS Program, 11344 Coloma Rd., Suite 560, Gold River, CA
95670. (800) 369-7437 (toll-free), (916) 851-7437.
Schweibert P, Deklyen C. Tear Soup, a
Recipe for Healing After Loss. Portland, OR: Grief Watch,
2001. Available from Grief Watch, 2116 NE 18th Avenue, Portland,
OR 97212. (503) 284-7426.
Simon J. This Book Is for All Kids, but
Especially My Sister Libby. Libby Died. Riverside, NJ:
Andrews McMeel Publishing, 2002. Available from Andrews McMeel
Publishing, Simon & Schuster, Inc., 100 Front Street,
Riverside, NJ 08075. (800) 943-9839 (toll-free).
Wolfelt AD. Healing a Child’s
Grieving Heart: 100 Practical Ideas for Family, Friends and
Caregivers. Fort Collins, CO: Companion Press, 2001.
Available from Companion Press, Center for Loss and Life
Transition, 3735 Broken Bow Road, Fort Collins, CO 80526.
(970) 226-6050.
Wolfelt AD. How I Feel: A Coloring Book
for Grieving Children. Fort Collins, CO: Companion Press,
1996. Available from Companion Press, Center for Loss and
Life Transition, 3735 Broken Bow Road, Fort Collins, CO 80526.
(970) 226-6050.
This document was developed by the U.S. Department
of Health and Human Services, Health Resources and Services
Administration (http://www.hrsa.gov),
Maternal and Child Health Bureau under a contract with the
National Sudden Infant Death Syndrome (SIDS)/Infant Death Resource
Center, Contract No. [NIH IDIQ-263-01-D-0208]. The National
SIDS/Infant Death Resource Center is operated by Circle Solutions,
Inc.
National SIDS/Infant Death Resource
Center (NSIDRC)
8280 Greensboro Drive, Suite 300
McLean, VA 22102
(703) 821-8955
(866) 866-7437 (toll-free)
(703) 821-2098 (fax)
sids@circlesolutions.com (e-mail)
http://www.sidscenter.org (Web site)
Rev. 2005
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