Little People with Big Hurts

By Cathi Lammert, RN -

Most children who have a sibling that dies due to a pregnancy loss, stillbirth or in the first few months of life will experience a grief reaction.  However, often times, their grief is overlooked or discounted. Parents may be so overwhelmed by their own grief that they are unable to assist their children with their issues. Parents often ask me “Will my child be negatively affected by the death of their baby sibling?”  I have to say the answer to this question is, “Usually not, if the child’s grief is acknowledged.” In this article, I hope to provide some direction in ways to assist little people with their big hurts and ways to validate their feelings.

In Helping Children Cope with the Unexplained Death of Infant, the author, Dr. Charles Corr, outlines four basic psychological tasks that comfort grieving youngsters. These include:  Understanding what has happened, identifying and validating their feelings, commemorating the life of the sibling(s) who died, and learning to live and love again.¹ In the following paragraphs, I will address each of these tasks and provide insight and direction from my own experiences. In assisting with the difficult journey of grieving, one should note that a child’s personality, past life experiences, developmental stage, and past reactions to loss will affect his/her reaction to the death of a sibling.

Understanding What Has Happened

Very young children ages two and under do not fully understand what has happened, but they are aware of a change in their parent’s behavior.  Children sense that their lives have changed dramatically, and they may become irritable or clingy. Sometimes parents may not have the energy to meet the many emotional and physical demands of their little ones during the demands of their own intense grief. It is important to try to maintain a normal routine even if it requires the assistance of family and friends with the child’s care.

Preschool children need to have things explained in very concrete terms. We need to be careful with our words; children become confused with statements that are not literally clear, for instance things such as “the baby is sleeping with God.” This statement may cause them to be fearful of sleep and of God.  Also, children of this age do not understand the finality of death and think heaven is a place one can visit temporarily and that the baby is coming back after a while.  Parents may become frustrated as children have repeated questions.  Often simple answers will suffice as children do not want detailed explanations. As the child matures, he/she will have a better concept of death.

School-age children are often frightened by death. They may have fears of sleeping alone or being apart from their family. They may need extra reassurances and more time with you.  Also, children of this age are very curious. Of course, this means they ask many questions and want more detailed explanations. All questions need to be answered and if we as parents do not respond to these questions, their peers will. Other children’s explanations may confuse and upset them even more.

Identifying and Validating Feelings

Parents have shared with me their concern about their preschooler because he or she is sad one minute and happy the next. Preschoolers grieve in spurts and the intensity is not as great as that of an older child. Often, children of this age will act out their feelings through their play. This is very therapeutic and is a way for them to positively release their feelings. Like adults, children respond to grief in many different ways. They may act out their anger by being destructive. It is important to acknowledge this anger and frustration so they can move past it. It can be helpful for them to have a punching bag or pillow to release those feelings. It is also important to have conversations about the loss your family has experienced and how your child has responded to the death with the child’s teachers, coaches, scout masters, and other caregivers. It is helpful to also give these individuals some bereavement literature on ways to help children with the death of a baby.

Commemorating the Life of the Sibling(s) Who Died

A large number of people in our society believe children should not be exposed to death. Parents often are not sure if they should include their child/ren at the time of loss, at the funeral or in the commemorating in the years to come. Parents know   their children better than anyone so these decisions are very personal and what is right for one many not feel right for another.

The parents of children who experience early pregnancy loss may find it more difficult to commemorate this life as often the only tangible evidence they have is an ultrasound picture.  Some commemorative ideas that families experiencing early losses have used are organizing a memorial service at their church, participating in a quarterly group burial service, or having a private intimate service with their family. Others have planted a tree or designed a garden.  Some families find connecting to a specific object such as a teddy bear or a piece of jewelry for themselves and the children is meaningful.

When there is a funeral and a viewing of the baby, sometimes parents are not sure about how to involve the children. The child may or may not have seen the baby at the hospital.  Talking to them about the choice and informing them what to expect at the viewing and the funeral helps the child and parent make a decision.  Some children may come to just the viewing and not the funeral and some want to be a part of the entire ritual. It is always helpful to have someone there to support the child/ren in case the parents need to leave.

Most children love to draw, color or write poems or letters.  Giving them the opportunity to create a special picture or letter to place in the casket may bring them comfort. Children loved to have their own keepsakes and may find having a special stuffed animal, piece of jewelry, baby’s handprints or footprints, and/or baby’s picture quite helpful. This connection to the baby may be a treasure for years to come.

Annual memorial services or walks held by support groups are a wonderful way to involve children. Sometimes at the time of the loss, the children may not have been a part of the initial ritual. Group memorials are opportunities to share with other bereaved families and a means to positively remember their baby.  This may be the first time a child has had an opportunity to remember their sibling.  At memorial services, children as well as parents can participate by writing a message on their balloon and releasing it, placing a holiday ornament on a tree or lighting their own candle.  

Lastly, family rituals such as placing flowers on the grave, releasing balloons, lighting candles, planting special plants etc in honor of the baby on birthdays, anniversaries, and other difficult days can be helpful. Some families have found planning something special with their children during those remembrance days such as an outing to movie, dinner or even a day trip is a positive means of healing with their family.   

Learning to Live and Love Again

Children will not forget their experience of having a baby brother or sister die.  However, they will be able to lead productive, wonderful lives if given permission to openly mourn and have their feelings validated. They need support and understanding of their grief in order to be able to integrate this loss into their lives.  As they move through each developmental stage, new questions may be asked, and they may need more in-depth answers.  This does not mean they are regressing, but rather they are maturing and need to clarify some issues in their hearts and minds. Some children adjust to this loss easier and others need extra help with a support group or therapist. 

In closing, your children are often your greatest source of comfort. Their openness and non-judgmental attitudes may allow you to express yourself and give permission to talk about your baby.  Bereaved children have learned about grief at often a very young age. However, often with a grief experience, growth does occur and gifts such as compassion and kindness follow. These may be the best of many gifts their brother or sister has left them.

¹Charles Corr, PhD., Building Blocks:  Helping Children Cope with the Sudden and Unexplained Death of an Infant, (SIDS Resources, Inc. Missouri Department of Health, Division of Administration, P.O. Box 570, Jefferson City, MO)

Sharing Newsletter: Volume 18, Issue 1; National Share Office, www.nationalshare.org

Cathi Lammert, R.N., is Executive Director of the National Office of SHARE Pregnancy and Infant Loss Support, Inc. www.nationalshare.org.  As a bereaved parent, Cathi combines her personal experience with her education and professional background as an obstetrical nurse. Her son, Christopher Michael lived just 4 days and died due to Hydrops Fetalis, a complication of Rh sensitization.  Cathi was a guest on the radio show Healing the Grieving Heart with Dr. Gloria & Dr. Heidi Horsley, to discuss Finding Help and Hope After Pregnancy Loss.  To hear Cathi being interviewed on this show, click on the following link:  www.voiceamericapd.com/health/010157/horsley011509.mp3  For more information, you can e-mail Cathi at:  clammert@nationalshare.org

Loss of Infant Twin Inspires Mother to Share Story

By Beth Larson - In 2001 I gave birth to my twin daughters Madelyne and Shirley. They were only 26 weeks gestation, and I had been in the hospital on bed rest because the water around Shirley broke everyday starting at 19 weeks. I was in the hospital for 7 weeks, laying there praying and watching my other two children, Alexander and Emmalynn, ages 3 and 5, come to visit me.  I was terrified, my husband was anxious and the children were scared because Mommy was not at home.

When I went into labor I knew that I had 50/50 odds of viable babies and I also knew that Shirley would be in more critical condition than Madelyne. As soon as they were born I called for the hospital priest to baptize them, and then 12 hours after her first attempt to take a deep breath my Shirley flew home to the angels from my arms. We were devastated, and we still had Maddy fighting for her survival.   I can only say that I would never wish this place of paradoxes on any parent, sorrow that my daughter died and joy that my other daughter lived. The next 3 months we went everyday to the NICU to sit with Maddy. Alex and Emmy went with me as well as my mother. They were such curious little buttons and everyday they asked where their other sister was, and my heart was torn asunder all over again.

The planning of Shirley’s funeral was almost beyond my ability. My husband and I struggled through that week in a daze. The hospital was kind enough to give us a resource packet, but I never found anything that would assist me in explaining what had happened to the other children. Every day they asked and each time I choked on my tears. They had a right to know, and I had no idea how to tell them.

Madelyne is my miracle baby, she has no complications and if you were to meet her today you would never believe my incredible story. I decided in my journey towards healing to write a book.  It is written in meter and easily understood by little children. I illustrated it with pictures of my “superheroes” Alexander, Emmalynn, Madelyne and my husband Justin, so that anyone who picked it up would feel connected to real people. Now, people who find themselves in my situation have a resource to help them explain to their children and even to themselves in a way, what has happened and the realization that joy and hope can be found again, not the same as before, but different.   My older children rescued me from despair, they lifted me on their little baby shoulders and taught me to laugh again, to smile, and to dream again. My fondest wish is that anyone who has lost a child will find comfort in this book, peace and blessings to you.

The title is “Shirley’s Garden.” I chose this because I have always felt guilty for not being comfortable visiting the cemetery. I would go there and see these elaborate gardens people made for their deceased loved ones, and I would think less of myself for not doing the same. Then I wrote the book, and it struck me that this would be my garden to my Shirley.

Please visit www.eloquentbooks.com/ShirleysGarden.html to view Beth’s information page.

When a Miscarriage Occurs After Fertility Treatments

By Kira Copperman, LMSW -

Being a patient at a fertility clinic brings moments of anxiety, hope, excitement, fear, and stress.  The time and effort to become pregnant can feel like an emotional roller coaster and certainly a different route to conception than one may have imagined.  A Harvard Medical School study showed that patients going through fertility treatments experience comparable levels of stress to patients who are going through treatment for cancer and heart disease.

This is no surprise as patients experience the daily, weekly, sometimes hourly ups and downs as they are progressing through their treatment. The focus of all of these treatments leads up to the day the pregnancy test is taken.  Many couples use up their financial, emotional and physical resources to go through treatment and they have a tremendous amount riding on the hope that their pregnancy test will be positive and that their journey was a success.

Regrettably, approximately 30 percent of all pregnancies (including fertility patients) result in a miscarriage, and being prepared to handle this type of loss is nearly impossible.  After going through all the treatments to conceive a child, finding out that the whole process did not succeed in an ongoing pregnancy can result in a complex grieving process.

The feelings of grief may extend beyond the loss of the pregnancy to thoughts that the dream of having a family has been shattered, the loss of trust in how your body works, the feelings of being inadequate as a woman or couple.  It may involve questioning oneself, ones’ worth; it may result in feelings of guilt and shame. If it was an early miscarriage, your feelings might be minimized or invalidated or not understood by the people you turn to for support.  Because of the nature of the loss, some friends and family may not have even known that you were pregnant, which brings on additional considerations.

Women or couples who have experienced a miscarriage and are grieving need to experience their feelings for themselves and seek the help and support that will work for them when they are ready.  There is no right way to feel, no right way to think, no right way to behave. There is no correct length of time to wait before you think about trying again, no prescription for what to do or say after you experience a miscarriage.

There are many ways to get support if that is what you feel you need.  It has been shown that women who experience a miscarriage find the most support from other women who have also miscarried.  That shared bond can allow women and couples to learn how others have coped and to continue their way through their complicated feelings.

There is also an organization called RESOLVE that runs support groups locally for women who have miscarried.  Many hospitals and healthcare centers also run support groups for women who have miscarried.  There are websites, books, blogs, chat rooms, therapists, (see below) designed to provide outlets for you to express your feelings and to bond with others who have had similar experiences.

Miscarriage Resources

www.resolve.org      www.hopexchange.com

www.silentgrief.com      www.miscarriagehelp.com

Kira B. Copperman, LMSW, is the President of KBC Consulting www.kbcconsult.com, a boutique healthcare consulting firm that specializes in helping physicians, dentists and hospitals improve their frontline customer service. Prior to KBC Consulting, she was the Practice Manager for a large fertility center in Manhattan entitled Reproductive Medicine Associates of New York (RMA of New York).  While at RMA of New York, her experience with patients dealing with the emotional side effects that can accompany infertility had a profoud effect on her and was one of the main reasons she created KBC Consulting. Ms. Copperman is also a published author and presenter on topics relating to healthcare.

How Will You Remember Your Loved One?

by Carol O’Dell -

We avoid thinking about or dealing with death at every turn. Even caregivers who are caring for their aging parents try not to think about the inevitable end. Cancer, Alzheimer’s, heart disease, stroke, diabetes, combined with age will eventually claim the lives of those we love. And sadly, by not fully anticipating and participating in this momentous event, we’re left scared, in doubt, and not knowing how to die-or be with someone we love when the time comes.

Who will teach us? How will we learn?

I recently interviewed Rachel, a young mother in my community who experienced a tragedy-she lost her two year old little boy, Tyler, in a swimming pool accident.

As I sat with Rachel and listened to her story, I immediately sensed she had wisdom and insight well beyond her years. She’s handled grief with grace, forgiveness, and determination. My own worries seemed insignificant.

Rachel’s story got me to thinking. How will we remember our loved ones? What memorial, statue, headstone or story will honor those who have touched our lives?

While I have nothing against cremation, sometimes people need a place to go-it’s important to create a sanctuary or sorts-a place to be, to pray, to think and meditate. A place to remember.

My Daddy is buried in Atlanta, and so this Father’s Day, I’ve had to create a new place for “us” to meet and talk.

I like to spend a few minutes catching up with my daddy about my life. I have a bench overlooking a lake in my backyard. He would have liked it here. He loved to sit outside and talk. That’s where I’m headed this Sunday.

I’m including an article I recently wrote about Rachel and a place of remembrance for all those who have lost someone they love. As you read her remarkable story, I’m sure you’ll agree-we can all learn from her-how to love, and how to hope again.

Angels Among Us

There’s an angel on Amelia Island. The childlike face lifts toward the sky, arms outstretched as though holding something invisible, and bronzed wings gleam against the stark Florida sun. The inscription at the bottom of the statue reads, “Angel of Hope.” It is encircled by a short brick wall and eight benches for seating with a loved one’s name on each one. I found this “Angel of Hope” one afternoon on a photography/bike trek around the island.

I stopped to take a picture and began to read the inscription on the back of the statue: “The Christmas Box Angel,” and I thought of Richard Paul Evans’ book, The Christmas Box, about a woman who mourns the loss of her child and finds comfort at the base of an angel monument.

At the base of the angel I read, “For all the children” and began to put it together-the benches, the names, the stones lined up at the base, the bouquet of flowers indicating someone had been here. 

This angel is a place of remembrance for families who have lost a child. It’s a sacred gift given by other bereaved parents and is available to anyone who would like to come, sit, and remember. 

I thought of Tyler, a purely sweet loving laid-back two-year old with beautiful big brown eyes, the son of Rachel and Patrick Pennewell. I remembered the day I found out Tyler had suffered a swimming pool accident.

Rachel, his mother told me, “Tyler was our angel. He had a purpose in being here. Sometimes I would just look at him. He was such a calm, knowing soul, and I’d wonder, you know something, don’t you? Some things he understood here on earth.”

After Tyler’s passing, Rachel and Patrick found the community of Nassau to be their angels who sustained them in those early weeks and months when shock turned to grief. 

“I’ll never be able to thank the people at our church and in our community for all they did. How can I ever show them what this meant to us?”

Rachel said it’s so important for bereaved parents to find ways to give back because, “What else can we do? You don’t stop being a parent. You have to find a way to give, and in that giving, your child lives on.”

I asked Rachel how she got to a place of peace.

“Tyler’s life completely transformed the way I saw myself, and that lives on today. He brought such peace into my life, from the moment of conception on; it was as if he had a mission. Patrick and I now have a second child, Hannah, Tyler’s little sister. I promise, Tyler helped pick her out. In so many ways, he’s still with us. He’ll always be with us.”

As I stand in this circle and read the names on each of the benches that surround this angel, I wonder who each one of them are, what their stories are, because it’s our stories that connect us-not the how did-he-die stories-but the deeper question: how did he live?

This Amelia angel creates a circle of hope; the hope and belief that each child’s life, no matter how short of a time they spent on earth, is a gift. If you look closely at the angel’s right wing, you will see the word “hope.”

The golden moments in the stream of life rush past us

 and we see nothing but sand;

the angels come to visit us,

and we only know them when they are gone. 

                                                                                                          ~George Elliot

Christmas Box Angels are erected in more than 25 other communities around the world.  http://www.richardpaulevans.com/statue.html

If you’d like to view a photograph of this statue, it’s posted on my website at http://home.comcast.net/~cdodell/ (www.mothering-mother.com) on the Caregiving Tips page.

~Carol D. O’Dell

Author of Mothering Mother: A Daughter’s Humorous and Heartbreaking Memoir available on Amazon

www.mothering-mother.com