Category: 6. Supporting children

The death of a baby at any time can be a major bereavement for the whole family. It will have an impact on children who were expecting to have a new brother, sister, niece, nephew, or cousin, or a surviving child of a multiple birth, and also on brothers and sisters born after a baby has died. Children in the wider family, children of close friends, and friends at school may also be affected.

This section considers ways in which to share the news of the baby’s death with their siblings and other children who may have known or known about your baby. This section is written for parents but could also be useful for relatives, friends and people including nursery and school teachers who are able to provide support.

Important dates, such as the anniversary of the date when the baby died or was due to be born, or occasions traditionally celebrated with family, such as special holidays, can be especially sad for parents. It can be helpful to talk to children in advance about any dates on the calendar that might be more difficult than others, so that they are aware that you may be sad again for a while. Do not be surprised if a child also shows signs that important dates and the lead up to them, trigger feelings of grief for them too.

Holidays and other times when families gather together can be a time when the baby is especially missed. Family birthdays, and especially those of a surviving twin or multiple birth, can also be bitter-sweet. Some families do something special to remember their baby on these occasions such as lighting a candle for the baby or choosing a special decoration together.

Many families mark anniversaries or other special occasions by lighting a candle, baking a cake for the baby or visiting a special place, such as the baby’s grave, the place they scattered their baby’s ashes, or another place that has strong associations with the baby. If you celebrate Christmas, hanging a stocking for the baby or putting ornaments on the tree in their memory, might help other children. Children can be involved in any of these activities and this can provide comfort and ways to acknowledge the grief that is felt by the whole family. You may also want some time on your own whenever grief resurfaces. It might be helpful to explain as to why this is, rather than risk further upset and confusion at what might already be a time of heightened emotions.

There are different ways in which you could involve your children and help them feel part of what is happening around them. You could ask if your child would like to come to the hospital to see the baby and say goodbye. If you are going to be bringing your baby home, you could explain that this is so that the whole family can say goodbye together.

Many parents collect keepsakes of their baby which can be stored in a memory box. Other children might want to add something of their own to the box. Depending on their age, they could do a drawing or painting, or write a poem or a letter. Some children might want to give the baby a cuddly toy which could be placed in the coffin or kept in the memory box. Children might also want to help make a memory box for the family or to make one themselves. They might also like to have a photograph taken with the baby. Depending on your child’s age, you might like to take them to the funeral and encourage them to participate in the service.

In the months following the funeral, you might like to take your children to visit their sibling’s grave, or a special place where you scattered ashes or planted memorial trees. Children may want to bring something special to leave on the baby’s grave. Some places have restrictions about what can be placed on the grave. For example, they may not allow items such as balloons, soft toys, pictures or wind chimes. It’s a good idea to find out in advance about any restrictions in order to avoid disappointing a child who wants to take a special item along with them.

You may also want to tell the parents of younger children’s close friends so that they understand if your child’s behaviour or mood changes. If they have not discussed death with their own children before, they may need time to think about what to tell them.

Some parents may offer to help by inviting your child to play or have a meal. However, some parents may decide to keep their distance in order to “protect” their own child from learning about death at a young age. This might feel painful for you and your child and your child may need to be reassured that they have done nothing wrong.

Anxiety about a young person’s own mortality and that of those close to them continues at this age. This combined with a natural need for independence and challenge may be a struggle. Teenagers can respond by engaging in an increasing amount of risk-taking behaviour and becoming angry more easily. This can be very hard for parents at a time when they may be feeling more anxious and protective of their other children.

Questioning the meaning of life is an important part of adolescence and bereavement can have a significant impact on this process. This can sometimes result in depression.

Adolescents may find it easier to talk to friends or a trusted adult rather than their parents. It can help to think about who this might be and support the teenager via this person.

Teenagers in step families can feel very conflicted about their place in the family and may need more reassurance than usual.

The understanding of children at this age is closer to that of an adult, although they may find the abstract nature of faith or less concrete concepts hard to understand. Like younger children they will need specific questions answering and find detail important. They may become more anxious about their own mortality and those around them.

It is important to listen to and acknowledge their concerns, and to put them in a realistic context.

It can help children to practise answering questions they may receive from other children, with information they are comfortable with.

Between the ages of 5 and 8 years, children begin to understand the difference between being dead and being alive, and between 7 and 8 years old they start to understand the permanence of death. Separation anxiety may increase or return at this point.

They may not ask questions but may be very interested in what is happening and why, so giving them the opportunity and time to ask questions is important.

They may “play” funerals or act out scenarios where a death occurs to help them process what is happening. This can be a good opportunity for you to gauge their understanding and concerns. Try to respond in a calm way, even if their responses may feel unsettling for you.

Young children may be beginning to understand the concept of death, but do not realise that it is permanent. They may well need repeated explanations of what has happened, before moving on to other seemingly unrelated questions or conversations very quickly.

You may find you feel anxious getting ready to tell them that the baby has died and their response is brief and then moves on to what might be for dinner, or if they can go back to playing. As their thinking is very much focussed on themselves and their world, they may need reassurance that nothing they did or said caused the death. It is also important that children of this age have a chance to understand why the baby died, as they may otherwise create fantasies and stories which may be much more frightening.

Children may also make the baby an imaginary friend. You may find this unsettling even though it is a common way for children to cope with their loss.

Even very young children usually sense when something is wrong. If they are not told what is happening, they may be frightened and imagine they are at fault for making you feel sad.

It is best to use direct language rather than words and phrases that also have other meanings. For example, telling a young child that the baby is sleeping could be confusing and worrying as they might not want to go to bed. Similarly, words such as “lost” or “gone” could lead them to think that they might also get lost or go away. These words could also lead to false hope such as thinking that the baby might wake up or be found. The child may worry about whether the same could happen to them or to you. Similarly, saying that the baby was unwell might frighten the child when they are unwell.

Like adults, children of any age may experience a range of feelings; these may not come in any particular order or at any predictable time.  Similar to those of adults, children’s feelings may be complicated and conflicting.

Children sometimes have mixed feelings when a new brother or sister is expected. A child who felt jealous during the pregnancy might feel guilty after the death of their sibling. It can be helpful to try to reassure a child that the death was nobody’s fault and that nothing they did or thought made the baby die.

Some children may feel angry towards the baby who died or towards their parents. Children may also fear that they or others close to them might die as well. They may be more upset than usual at being separated from their parents, especially if their mother is critically ill or has to stay in hospital.

As with adults, children, especially younger children, might find it difficult to express their feelings. Look for changes in behaviour, especially acts of going back to younger behaviours. For example, a child who is toilet-trained might want to wear nappies again or start wetting the bed. Children might become clingy or dependent. There might also be changes in eating and sleeping patterns, and there might be a tendency to fall sick. Maintaining a routine as far as possible is really helpful and giving lots of opportunity for children to ask questions.

It is common for children to express their feelings through play, drawing or painting. This can give you an idea of what your child is thinking and feeling as well as give them an opportunity to express how they feel. Consider what external support your child might need, either from relatives or friends, or through play therapy. Professionals such as your child’s health visitor, teachers, child minders and your health visitor, should be informed so that they can support your child accordingly. Winston’s Wish and Child Bereavement UK specialise in supporting bereaved children and have various resources available through their website.

Children will generally move through the broad stages of understanding as described below but there can be a great deal of variation. If a child has already experienced the death of a family member or friend or has a learning disability, this may affect their understanding and response. It is important to check their understanding even if they have been bereaved previously.

Telling anyone that a baby has died can be difficult. Telling children may be especially challenging as it can be hard to work out the right amount of information to provide them with and to explain it in a way that works for their age and ability. It is also difficult to offer reassurance to children about a situation that cannot be changed. If you do not feel able to tell your children what has happened, you may be able to ask a close family member or friend to tell them for you or help you to tell them. For example, this person could help explain what has happened and explain why you are sad. The person could also explain why they, rather than you, may need to look after them.

If your baby died on a neonatal unit, there may be a counsellor, psychologist or play therapist who could help you with this.

When deciding what to tell your children, it is natural to feel anxious and protective towards them. It is important to consider their age and their ability to understand. Try not to let any possible fear that they might get upset determine what you tell them. It is important for children to know that it is okay to cry and that they might see you crying as well. When talking with your children, you might like to start by telling them what happened, without including too much detail. You could also say, “We are sad because our baby has died. When someone dies, it means that we won’t be able to see them again.” You can then be led by their questions. You might like to include the baby’s name if you have one and the gender if this is known. Let your children know that they can come back to you to ask questions at other times. They may accept your simple explanation and immediately change the subject, or carry on with their previous activity. This is very normal.

Young children who visited the baby in neonatal intensive care might have believed that the baby would get better and go home. They could be confused and distressed as to why this has not happened. It is likely that their own lives were disrupted as their parents spent long periods of time with the baby in hospital. They might also have started to develop their own relationship with the baby. It is important to encourage them to talk about how they are feeling and to explain why the baby died.

Some children might like to know about the funeral or ask where we go when we die. You might have religious beliefs that could influence your answers, or wish to provide more secular or neutral answers such as “Some people believe…” or “We don’t know where people go.”. For young children, focus on what might happen at the funeral so that they know what to expect. Young children might need reassurance that the baby can’t feel anything. Otherwise, they might find the idea of a burial or cremation frightening. You could say, “When people die, we bury them.” or “When people die, we cremate them.” and explain what this means.

One way to help younger children understand death and dying is to read them books for children that discuss these topics in an age-appropriate manner. You could ask a relative or friend to do this for you. The Sands online shop stocks various children’s books that you can order as does Winston’s Wish. You can also check your local library for appropriate books.