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The Grieving Child and Family

June 24, 2024

Editor’s Note: Jenny is the mother of two children with special healthcare needs and a Patient & Family Advisor at her local children’s hospital. In addition to her lived experience, Jenny calls upon her professional experience as a social worker to help her write blogs from her home in Wisconsin. –Cara L. Coleman, JD, MPH, Associate Editor, Pediatrics

Family Connections with Pediatrics

When my daughter was three years old we said goodbye to our beloved cat, Eleanor. My daughter did not understand why it happened, but she did understand that her kitty was gone forever. When we told her the news she cried, and we cried with her. She asked hard questions, and we did our best to answer. She told us her favorite Eleanor stories, and we shared in those joyful memories together. These conversations were not easy but I am glad we had the chance to practice because 18 months later my daughter had to say goodbye to her grandmother as well.

Death is a normal part of life, but from an early age, children learn not to talk about it. They learn that death can make adults feel uncomfortable, that grief is something to hide. They do not want to add an extra burden to their grieving family members so instead they stay silent and go through the process alone. This can leave children feeling confused, isolated, and overwhelmed. This month’s Pediatrics addresses this challenge in “Supporting the Grieving Child and Family: Clinical Report” (10.1542/peds.2024-067212).

What does grief look like in children?

Much like adults, children experience grief in many different ways. This may include feelings of guilt, shame, and a sense of responsibility. Children may feel like there was something they should have done to prevent the death and may worry about their own health and safety. Many children also experience secondary losses after the death of a loved one. These include:

  • Moving to a new home
  • Change in social circles
  • Loss of shared memories
  • Decreased time with surviving adults

Death brings up big feelings and hard changes. Children may wonder if they will ever feel happy again.

What are some best practices when supporting a grieving child?

If a child is grieving the loss of a loved one, do not stay silent. This may communicate that their grief is not important. When talking to children about death:

  • Invite conversation
  • Listen and observe
  • Be authentic and honest
  • Encourage them to express their feelings

Sometimes the best thing you can do is simply be present for the child; let them know they matter.

What are some common pitfalls to avoid when supporting a grieving child?

When talking to children about death, it is best not to do the following:

  • Try to cheer them up
  • Tell them to be strong and hide their emotions
  • Make comparisons with your own experiences
  • Assume you know the reason for their worry or sadness
  • Believe cultural stereotypes instead of supporting each family individually
  • Allow your own grief or discomfort to get in the way of supporting a child with their grief

Remember to approach each child with an open mind; let their thoughts and feelings guide you.

What can you do with this clinical report?

  1. If your child and family are grieving, share this report with your child’s doctor. It contains a lot of practical advice, helpful resources, and conversation prompts.
  2. Schedule follow-up appointments with your child’s doctor around the anniversary of the death or other special events. This may be when your child needs the most support.
  3. If a loved one recently died, consider bringing your child to the funeral. This report offers guidance on how to prepare children and talk to them about what they may see and hear.
  4. Recognize and respond to your own grief. If needed, seek help from a support group, counselor, or community-based mental health services.
  5. Visit your local library and ask the librarian to help you find children’s books about death, loss, and grief. Books can be a wonderful tool when you don’t know what to say.
  6. For additional information and resources, check out The Coalition to Support Grieving Students (
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