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Helping Children Cope with Grief 

When an Infant Dies

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 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.”

(Fitzgerald, 1992)

“If a child is old enough to love, 

He or she is old enough to grieve.”

(Goldman, 1994)
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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.

Age Child’s Reactions How To Help

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.

Talk without criticizing or judging.

Be willing to talk in the teen’s time frame.

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.
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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.

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.

Selected Organizations that Provide

Support and Services to Bereaved Children

The Dougy Center

National Center for Grieving Children, P.O. Box 86852,

Portland, OR 97286. (503) 775-5683, help@dougy.org (e-mail),

www.dougy.org (Web site)

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 www.griefnet.org or http://kidsaid.com

Raindrop. A cartoon story that explains death to children.

www.iul.com/raindrop

The Waterbug Story. A brief, beautifully written story on death—

for all ages. www.fortnet.org/WidowNet/poems/waterbug.htm

“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.” 

Joni Nelson Horchler & Robin Rice Morris

“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.”

Willinger et al, 1991

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.

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
4 July 2005

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,

3164 Gold Camp Dr., Suite 220, Rancho Cordova, CA 95670.

(800) 369-7437 (toll-free), (916) 266-7437.

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 (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)

www.sidscenter.org (Web site)