Talking to children about the death of a baby is difficult, especially when we are having trouble understanding it ourselves.  It can be helpful to know that children are likely having the same emotions and questions.  Answer their questions honestly and appropriately for their age.  

Many parents ask if they should tell their children about the baby that has died.  This is a personal decision and will depend on the circumstances, but children almost always sense that something has happened to upset the adults in their world.  Similar to adults, they are often frightened when their questions aren’t answered or they don’t have explanations for the emotions suddenly surrounding them.  

Some children feel very strongly that they do or do not want to see their sibling.  They should not be pressured to do something they do not want to do.  Some children are curious and may have questions that are difficult to hear, but it is helpful for the children to have answer to these questions.  Many families treasure having a photograph of their children together, while some will use photographs to show older children the baby at a later time.  

If you choose not to have children see the baby or this isn’t an option for other reasons, you may share other items connected to the baby.  For example, handprints and footprints a blanket that was wrapped around the baby, or a memory box.  Children may enjoy choosing items to be included in a memory box.  

Children can also be included in a memorial service or other rituals.  If you choose to have your children attend a memorial service or participate in rituals, be sure to talk to them about this so they know what to expect.  It can also be helpful to have another adult to support and help them if needed.  

If your child was looking forward to the new baby as you were, he/she may have many questions and feel the sense of loss, too.  Talk to children using terms they can understand.  Be clear and honest and try not to over-explain.  It’s ok to cry and share that you are sad, too.  

Avoid metaphors that the child may not understand.  For example, if they are told the baby ‘went to sleep’ and didn’t wake up, then they may fear going to sleep themselves.  When parents say they ‘lost’ the baby, a young child could worry that his/her paents will lose him/her, too.  

If your child has not have previous experiences with death, they may need a simple explanation.  For example, ‘when you die, your body stops working’.  If you have religious beliefs about the death process, you may choose to share these with your child.  If you are assisting someone else’s child, it is best to talk to the child’s parent(s) about what they want their child to hear regarding these concepts.  

Give children an opportunity to ask questions and let them know they can ask questions any time they think of them in the coming weeks.  

Many children like to hear what adults do when they are sad.  Share things you find comforting during these times.  This can help them think about what coping skills they might like to use.  You may notice children following your behaviors because they are looking to you to model appropriate behavior in this situation.  

Developmental Stages
A child’s ability to understand death and dying will depend on his/her age and developmental level.  Very young children may be more fussy or clingy, have changes in their eating or sleeping habits, and may fear going to sleep at night.  They often feel safe and secure with lots of hugs and snuggling.   

Preschool-age children often have imaginative thinking and believe happy endings can magically appear.  They also think something easy caused the baby’s death, including something they said or did.  They often fear that they could die, too.  Simple and consistent messages are important to helping them understand.  

School-age children usually understand that death is forever.  They may try to avoid items or places they associate with the baby.  The fear that they did something to cause the death is also common in this age group.  Parents often notice that these children are sympathetic and will try to make the parents feel better.  Help them understand it is not their responsibility to take away the sadness of his/hear parents.  

In early adolescence, children begin to think more abstractly and may have more questions about what happens after death.  These children often enjoy helping to plan a memorial service or participate in other rituals.  They may be very angry or upset that this loss is unfair.  

Teens appreciate adults who listen to them rather than tell them how to act or feel.  For some teens, they will be drawn closer to the family during this time.  Others, however, may withdraw and look to their friends for support.  

What to Expect
Some children will not be vocal about their emotions, but will show them through play, art, stories, and music.  It is normal for young children to show some behavior changes.  It is also common for them to argue more, disobey rules, be pleasers, or seek more attention.  Continuity of rules and expectations from before the baby’s death will help to minimize these actions and provide familiar structure.  

Some children will have nightmares, headaches, digestion problems, or difficulty sleeping.  If they are prolonged or severe, the child should see his/her health provider.  Professional counseling is also available for children who are having prolonged or extreme behavior changes, express throughs about hurting themselves or others, or are struggling with symptoms of depression or anxiety.  Pediatricians, family physicians, school nurses, social workers, school counselors, psychologists, or religious leaders can work with your child or refer your child to appropriate services.  

In the years to come, children may re-process this experience within their new developmental level and thinking.  This can surprise parents or parents may not understand why a child who seemed to be healing is suddenly showing signs of acute grief.  This is a normal part of incorporating this life experience into their knowledge base and understanding of self.  As during the first several weeks, encourage the child to ask questions and offer clear, honest answers.  

If you are concerned about your child’s physical or emotional health or do not feel you have the ability to meet your child’s needs during this time, please ask for help.