Helping Children Cope with the Sudden and Unexpected Death of an Infant

Introduction
The focus of this webpage is on how children cope with grief developmentally as Preschoolers, School Age Children and Adolescents and ways in which adults can help. It serves as a quick reference for assisting children as they learn to understand the death, find positive ways to respond to the loss, commemorate the baby’s life, and move on with living and loving. It is important to remember that each child is an individual and that each situation is unique. This information is to be used only as a guide. Feel free to adapt what fits for you and the children you are helping. In addition, you will want to incorporate any of the explanations or commemorative activities, which appear here to fit your own cultural and religious beliefs.

PRESCHOOLERS

Understanding a Death
Children in this developmental group may:

  • Not believe death is final (baby will wake-up or return).
  • Have only a limited concept of time (baby will come back someday).
  • View death as avoidable.
  • Believe their actions or wishes caused the death.
  • Live in a magical world where they believe anything can happen, especially if they wish hard enough.

Responding to a Death
Children in this developmental group may:

  • Become irritable.
  • Cry readily without apparent reason.
  • Experience changes in eating habits.
  • Regress to thumb sucking, bed wetting, or soiling.
  • Develop fears of abandonment, separation, or vulnerability.
  • Develop night terrors or fears of sleeping.
  • Become afraid of the dark.
  • Become unable to concentrate.
  • Withdraw from friends and family.
  • Become depressed or appear indifferent.
  • Experience guilt and feel responsible.
  • Blame themselves for thoughts, feelings, or actions before the baby’s death.

Commemorating a Life
Children in this developmental group may:

  • Need to be physically involved or included in funerals or other activities that commemorate the life of the baby.
  • Want to share in all aspects of the family’s grief work.
  • Need to express their feelings, ask questions, and receive age appropriate responses from someone they trust.

Moving on After a Death
Children in this developmental group may:

  • Exhibit concern that going on with life may seem to imply “forgetting” the dead sister or brother.
  • Need approval or permission to be happy once again without feeling guilty.
  • Feel some loss of confidence about their ongoing role or place in the family: “Am I still a big sister or brother?”
  • Require assistance in learning to love and trust again.

Ways to Help Preschoolers Cope with Loss

  • Be a good observer of what the child is saying, feeling, and doing.
  • Ask someone outside the family, who is valued and trusted, for feedback about what they notice about the child. This can help in picking up clues about how the child is understanding and responding to the death of the baby.
  • Be a good listener for the child. What is he or she asking or not asking? What is behind his or her questions? For example, a question about whether or not others will die may reveal underlying concerns about the child’s own security.
  • Use concrete, truthful language to explain the death and to answer a child’s questions. What you say should be reliable and should be expressed in ways that the child can understand.
  • Expect to have to repeat explanations about the baby’s death over and over. Children often find comfort and learn best through repetition. Be patient with the child and with yourself.
  • Remember that children may not have life experiences, which enable them to understand the baby’s death. Share with them your own life experiences in constructive ways.
  • Ask the child to tell you what he or she understands about what has happened. This is a way of determining what he or she understands about what has happened. This is a way of determining what he or she knows or does not know about the situation.
  • Similarly, ask the child to repeat his or her understanding of your explanations about what has happened.
  • Reassure the child that the baby’s death was not his or her fault. Explain that there was nothing that anyone could have done to prevent the death. Reassure preschoolers that SIDS only happens to babies, not to them.
  • Try having a friend, relative, or neighbor read an age-appropriate book about coping with loss with the child.
  • Help the child to find constructive and socially acceptable ways to express strong feelings. For example, children might act out their feelings through running, riding a bicycle, or punching an old pillow.
  • Share your own feelings of grief in ways that do not overwhelm the child. It can be very helpful for a child to learn that adults feel sad and cry sometimes.
  • Help the child to identify and give names to feelings as they arise. Use basic words like “sad,” “mad,” “glad,” and “scared.” Linking these feeling words to behaviors may help children to give voice to their feelings, rather than acting them out inappropriately.
  • Give extra hugs and reassurance to a child at this stressful time. This will probably help both the child and the adult to feel better.
  • Encourage the child to join in planning activities to commemorate the life and special qualities of the baby. For example, the child might want to draw a picture to remember the baby or help decide what the family should do on holidays or the anniversary of the baby’s birth. The important thing is to include the child in planning commemorative activities.
  • Help the child to make a memory book. Include photographs, mementos, pictures drawn by the child, and any special memories of the baby.
  • Allow the child to select and keep a personal item that belonged to the baby, such as a stuffed animal or music box.
  • Give the child permission to talk about his or her brother or sister and to keep memories of the baby. This can be done by talking about the baby from time to time with the child. Adults can also help a child by sharing things they remember about the baby or about special times that the family had together.
  • Provide the child with a model of ongoing living after a loss by demonstrating in your own life that sadness about the baby’s death can be compatible with living and loving. This will confirm for surviving children that without forgetting the baby, good grief work can help make life worth living again.
  • Provide children with a consistent, caring and secure environment that will enable them to begin to love and trust again.

SCHOOL AGE CHILDREN

Understanding a Death
Children in this developmental group may:

  • Realize the finality of death, but may not realize that death is something that happens to everyone eventually.
  • “Rework” the memory of the baby’s death by talking about it over and over.
  • Show a tendency to think that death can be avoided.
  • Become preoccupied with physical and biological aspects of death.
  • Ask detailed questions about caskets, cremation, cemeteries, or what happens to dead babies.

Responding to a Death
Children in this developmental group may:

  • Become fearful after the death about things that have never bothered them before. For example, they may become anxious about sleeping in the dark, being alone, or the likelihood of their own death.
  • Feel responsible for things that happen in the world around them, and may believe that their own thoughts or feelings of anger or jealousy toward the baby contributed to its death.
  • Engage in tantrums, “acting out” behaviors, or other ways of expressing anger that had not previously been characteristic of the child.
  • Regress or return to immature behavior and dependence.
  • Withdraw or become quieter, exhibiting a tendency to be alone and showing decreased interest in other persons, play, or favorite activities.
  • Experience morbid dreams and nightmares.
  • Become exceedingly anxious when separated from parents(s) or other adults, and may feel that something “bad” will happen.
  • Exhibit extreme obedience and compliance, such as “I’ll be so good nothing else will happen,” or “I’ll be good and Mom and Dad will be back like they used to be.”
  • Display loss of appetite or overeating.
  • Experience sleep difficulties, such as being unable to sleep or waking often.
  • Encounter exaggerated mood swings from highs to lows.
  • Have difficulty concentrating, sometimes leading to declining school grades.
  • Re-enact life experiences through play, such as pretending to be dead or pretending that their baby has died. (In these activities, children are practicing ways to express themselves and testing ways to cope with life events.)
  • Express their feelings through drawing, writing, painting, or playing with clay.
  • Hide feelings of sadness and appear to be “taking the death well,” even when that is not actually the case.

Commemorating a Life
Children in this developmental group may:

  • Be unsure whether or not they want to participate in memorial activities for the dead infant.
  • Be concerned about expressing their feelings in embarrassing ways during shared public activities.
  • Have their own definite ideas about ways in which they might want to commemorate the life of a dead brother or sister.

Moving on After a Death
Children in this developmental group may:

  • Feel guilty when they are playing or having fun after the death of a brother or sister.
  • Be concerned about “forgetting” or “betraying” the dead child.
  • Become anxious about their continued role and security within the family system: “Am I still a big brother or sister?”; “Am I in some sort of danger because of what happened to my little brother or sister?”
  • Need permission from adults to move on with their lives, to continue to love and find happiness in life.
  • Revisit loss and grief from time to time when those experiences are rekindled by developmental tasks or life events.

Ways to Help School-Age Children Cope with Loss

  • Be aware that all children in the same developmental or age group do not react and respond in the same way.
  • Be honest; do not lie or tell half-truths; what you say to a child should be reliable and consistent with the family’s cultural, ethnic, and religious beliefs.
  • Do not wait until one big “tell-all” to help children understand loss.
  • Encourage children to ask questions about the death.
  • Provide simple, factual information about death, loss, and grief. Use the words “dead” or “death,” instead of phrases such as “he went away” or “God wanted her.”
  • Let children know you really care about their feelings.
  • Listen and respond to what the child is telling or asking you.
  • Understand when children do not act sad. (Play is a child’s work and happy moments may represent a needed defense against overwhelming sadness.)
  • Allow children to participate in activities designed to commemorate the baby’s life, but do not force them to do anything hurtful or uncomfortable.
  • Understand that grieving takes a long time; each child mourns in his or her own ways and at his or her own pace.
  • Seek outside help if you are doubtful about or have questions regarding the child’s responses or reactions.
  • Learn from the children.
  • Share your own feelings of grief with the child in appropriate ways.
  • Maintain order, stability, and security in the child’s life.
  • Give children permission to move along with their lives and activities.

ADOLESCENTS

Understanding a Death
Children in this developmental group may:

  • Have a clearer concept than younger children that everyone will die eventually.
  • May be confused by the unpredictable, sudden death of an apparently healthy baby brother or sister.
  • Focus on the loss of the baby’s future and what will not be achieved, experienced, or shared.
  • Uncharacteristically withdraw from the family and spend more time in his or her room alone or become unusually angry or aggressive for no apparent reason.
  • Ask questions about the circumstances and the cause of the baby’s death.
  • Ask broader questions about grief and loss or about processes of mourning.

Responding to a Death
Children in this developmental group may:

  • Share or may not share his or her feelings in a direct way.
  • Engage in careless, reckless behavior, almost as if they are flirting with danger and defying death.
  • Feel a special responsibility for taking care of parents and/or other family members, especially if he or she is the oldest child.
  • Seek support and understanding from friends and/or adults outside the family, such as teachers, clergy, or neighbors.
  • Feel a great deal of anger about the death of a baby sister or brother and may act out their grief in healthy and appropriate ways such as sports or hobbies, or in unhealthy and inappropriate ways such as abusing alcohol and drugs.

Commemorating a Life
Children in this developmental group may:

  • Assume a leadership role with younger siblings in commemorating the life of a baby brother or sister who has died.
  • Have a special need to remember events and experiences that the family had with the baby, especially if he or she had been a caretaker.
  • Have difficulty participating in public ritual because of concerns about displaying strong emotions and embarrassing themselves.

Moving on After a Death
Children in this developmental group may:

  • Find it difficult to move on with their own grieving and living, especially if they have been obliged or have felt obliged to take on the responsibility of caring for other family members.
  • Reconsider how their future plans impact on their family, for example, plans to move into their own apartment, go away to college, or relocate for a job.
  • Feel guilty about rebellious or defiant responses to parental authority that are typical normal development.
  • Mistakenly come to believe that somehow, through their lives or their behavior, they must “make up” for the dead child.

Ways to Help Adolescents Cope with Loss

  • Be alert to nonverbal behaviors of adolescents following a death-related situation. While they may be unable to tell you directly about their pain, they may be expressing it by being quiet and moody or by acting in a dangerous and reckless manner.
  • Be willing to share your own thoughts and feelings about the baby’s death and how you are choosing to cope.
  • Be open to listening and talking about anything that an adolescent may wish to explore, such as the circumstances and cause of death or the pain of the loss and the processes of mourning.
  • Be patient. These conversations may take a lot of time, energy, and understanding on your part-which may be difficult for a grieving adult to provide. However, this will be time and energy well spent for both you and the adolescent.
  • When an adolescent acts out his or her grief in an angry way it is first important to acknowledge and respect this as an appropriate feeling. Then help him or her to find healthy and appropriate ways to channel the anger, such as through involvement in athletic activities, music, writing or dramatics.
  • Try to have a nonjudgmental attitude toward how the adolescent may be responding to the death even if you disagree. By providing acceptance of his or her feelings, it will increase the chances that he or she will continue to share them with you.
  • Help adolescents to find their own solutions to problems, rather than imposing your solutions upon them.
  • Tone of voice, eye contact, and touch are all powerful communicative tools that are the most natural ways to show trust, love, and caring between an adult and an adolescent.
  • When an adolescent does confide in you, it is important to respect confidences revealed in private.
  • Encourage adolescents to participate in family activities and decision making, seek their opinions, and praise their ability to handle responsibility in mature ways.
  • Adults need to provide adolescents with reassurance that it is okay for them to move forward with the life plans.

About the SIDS Resources’ Building Blocks Series
SIDS Resources works with families, friends, and child-care providers to offer support and to supply current, pertinent, medical information about SIDS. Ongoing support is available to families and friends through individual counseling, support group sessions, home visits, peer contacts, and research update meetings. SIDS Resources also offers education, support, and resources for professionals who serve individuals impacted by SIDS and for the community at large.

The SIDS Building Blocks Series is an informative collection of booklets designed to focus on the needs of individuals who have experienced the tragedy of SIDS and professionals who may encounter those who have experienced SIDS.

Select from the categories below to go directly to the relevant support information:

SIDS Building Blocks Task Force Members

    • Charles A. Corr, Ph.D., Chairperson
    • Lisa Baum, Funeral Director
    • Jan Boesch, SIDS Parent
    • Richelle S. Clark, RN, PNP, MHA
    • Pat Codden, RN, MSN
    • Lauretta Coleman, SIDS Parent
    • William Ferzacca, MA
    • Ronald Jones, Funeral Director
    • Robert Knight, MSW
    • Robert L. Lewis, Ph.D.
    • Jean McLane, SIDS Parent
    • Dorothea Mostello, MD, SIDS Parent
    • Pamela E. Paffett, Child-Care Resource and Referral Specialist
    • Rena Ridenour, RN, MSN
    • Claudia Sarber, SIDS Grandparent
    • Dave Sarber, SIDS Parent
    • Bridgette Sargent, Child-Care Provider
    • Sue Smorodin, SIDS Parent
    • Sue Treiffeisen, M.Ed.
    • Debbie VanRyn, SIDS Parent