The Long-term Psychological Impact of Child Bereavement on Families

The loss of a child is an unimaginable experience, and a path that no parent should ever have to walk. While a bereavement is always difficult, many studies provide evidence that the greatest loss, and often the most enduring one, occurs for parents who experience the death of a child. Parents typically expect to outlive their children, and the death of a child, no matter the circumstances, violates this natural order of life and death, often leading to intense shock and disbelief.

Society in general often finds the death of a baby or child very difficult to approach and therefore the subject often seems taboo. This can leave grieving parents and families feeling more isolated and alone in their grief.

There were 3,743 child deaths in England in the year ending 31 March 2023, according to the National Child Mortality Database. The highest death rate continued to be for children aged between 15 and 17 years, followed by 1- to 4-year-olds. Deaths of infants (babies under 1 year of age), accounted for 59% of all child deaths in the year ending 31 March 2023.

These figures do not take into account the various types of baby loss, including stillbirths. This is where a baby dies before they are born, after 24 weeks of pregnancy. According to Sands, in 2021, there were 2,866 stillbirths at a rate of 4.1 stillbirths per 1,000 total births for the whole of the UK. The loss of a baby is devastating and it may be difficult to know where to find the right support. Tommy’s offers support for anyone who has experienced the loss of a baby, whether through miscarriage, stillbirth, neonatal death, or termination for medical reasons. They can provide ongoing emotional and practical support for parents and family members.

Understanding Child Bereavement

The death of a child is a deeply tragic event that has unique challenges and complexities compared to the death of an adult. The death of a child often leads to intense emotional pain and anguish for parents and family members. It goes against the natural order of life, where parents expect to outlive their children. The loss can create feelings of guilt, anger and despair. Getting the right support is often vital for bereaved parents in order for them to be able to process the loss and move through their grief.

Parents may experience overwhelming emotions such as shock, disbelief, anger, guilt and profound sadness. This pain can be both physical and emotional, and it may feel like it will never end. Grieving the loss of a child is a lifelong process. Even as time passes, the pain may not ever leave, but it may change in its intensity and form.

For someone who has experienced the loss of a child, it can be difficult to accept the reality of what has happened, and it’s not uncommon to go through a period of denial as a way of coping with overwhelming emotions. There is often a long-term impact on mental health for bereaved parents. Conditions such as depression, anxiety, post-traumatic stress disorder (PTSD), and complicated grief are common among bereaved parents.

Immediate Impact and Acute Grief

Grief is a highly individual experience, and different people may vary widely in their responses to the loss of a child. The grieving process is not linear and may involve fluctuations in emotions over time as the loss continues to be processed.

The immediate psychological impact of a child’s death can be overwhelmingly distressing and can create a wide range of intense emotions. These may include:

• Shock and disbelief – initially, there may be a sense of complete disbelief and shock. The mind may struggle to comprehend the reality of the situation, leading to feelings of numbness or detachment. This sometimes happens in order to protect the person from the full force of the emotional pain.
• Intense sadness and grief – following the initial shock of what has happened, profound sadness and grief can set in. The loss of a child is one of the most devastating experiences a person can experience, leading to deep emotional anguish and sorrow. Someone facing this situation may experience overwhelming feelings of emptiness, longing and despair.
• Anger – anger is a common response to grief, particularly in cases where the death feels unjust or senseless. People often feel this way after the loss of a child as the innocent nature of children can create an intense feeling of injustice. People may direct their anger towards themselves or others. This is a natural reaction to the profound injustice and pain of losing a child.
• Guilt – feelings of guilt are also common, with people questioning whether they could have done something differently to prevent the death. Feelings of guilt can be especially pronounced in cases where the death was sudden or unexpected.
• Confusion and disorientation – the loss of a child can alter someone’s sense of identity, purpose and understanding of the world.
• Physical symptoms – the emotional toll of losing a child can result in physical symptoms such as fatigue, loss of appetite, insomnia, anxiety, headaches and muscle tension. These symptoms are a reflection of the profound stress and emotional strain experienced during the grieving process.
• Social withdrawal – grief can sometimes lead to social withdrawal as someone who is grieving may struggle to engage with others or participate in activities they used to enjoy. The intensity of the emotions involved may make it difficult to connect with others or find solace in social interactions. Unless someone has experienced the loss of a child themselves, it can be hard to truly understand the depth of the parents’ grief and the complexity of their emotions. This lack of understanding may make it challenging for people to know how to offer meaningful support and can make the grieving parent feel isolated from friends and family.

Prolonged Grief and Adjustment

The death of a child can have profound and lasting effects on parents, leading to prolonged or complicated grief reactions that may persist for years, or even a lifetime. It is important for parents who have lost a child to receive compassionate support and understanding as they navigate the complex and deeply painful journey of grief and healing.

The pain of losing a child is often described as unbearable and unrelenting. Parents may experience intense feelings of sadness, anger, guilt and despair, which can persist for years after the loss. The role of a parent is deeply intertwined with someone’s identity. The death of a child can disrupt this identity, leaving parents feeling lost and struggling to redefine themselves in the absence of their child. In cases where the child’s death was sudden, unexpected or traumatic, such as accidents, illness or violence, the traumatic nature of the loss can exacerbate feelings of shock, disbelief and horror, making it more difficult for parents to come to terms with their grief.

Society often struggles to understand and support parents who have lost a child, leading to feelings of isolation and complicating their ability to mourn openly and seek support from others.

Bereaved parents can also experience complicated grief, also known as prolonged grief disorder. This is a type of grief reaction characterised by intense and prolonged symptoms following the loss of a loved one. Some common symptoms of complicated grief include:

• Intense and persistent longing or yearning for the deceased.
• Difficulty accepting the death.
• Persistent feelings of emptiness or numbness.
• Difficulty engaging in activities or maintaining relationships.
• Feelings of bitterness or anger related to the loss.
• Avoidance of reminders of the deceased.

Psychological Disorders and Mental Health Concerns

The loss of a child can trigger deep feelings of sadness, hopelessness and despair, which can lead to clinical depression. It can be challenging for parents to find joy in life or engage in activities they once enjoyed. Depression is a mental health disorder characterised by persistent feelings of sadness, hopelessness and the loss of interest or pleasure in activities. It can affect how you think, feel and handle daily activities. Depression can vary in severity from mild to severe and can interfere with a person’s ability to function normally in their daily life.

Parents who have lost a child may experience heightened anxiety, constantly worrying about their own well-being, the well-being of their other children, or the fear of future losses. Anxiety is a feeling of unease, a feeling of worry or fear that can range from being mild to severe. Anxiety is usually experienced as a combination of physical sensations, thoughts and feelings. Anxiety can feel like you are constantly worrying about things, have a sense of dread and you may have difficulty concentrating.

Witnessing or experiencing the death of a child can lead to symptoms of PTSD, such as flashbacks, nightmares, hypervigilance, and avoidance of reminders of the traumatic event. PTSD stands for Post-Traumatic Stress Disorder. It’s a mental health condition that can develop after experiencing or witnessing a traumatic event. It can disrupt a person’s life significantly, affecting their relationships, work and daily functioning.

Grieving the loss of a child is an immensely complex process, and some parents may develop complicated grief disorder, characterised by intense, prolonged grief that interferes with daily functioning. They may struggle to accept the reality of the loss or feel stuck in their grief.

Interpersonal Relationships and Family Functioning

The strain caused by the death of a child within a family can be significant, impacting interpersonal relationships in numerous ways, including:

• Parental relationship – the loss of a child can affect the relationship between parents. Grief can manifest differently in each parent, leading to misunderstandings, blame or withdrawal. While some couples may draw closer together in their grief, others may experience strain as they struggle to cope with their own emotions while also trying to support each other.
• Siblings – the surviving siblings may experience feelings of guilt, confusion and abandonment following the death of their brother or sister.
• Extended family – the loss of a child can strain relationships with extended family members. Relatives may struggle to find the right words to offer support, leading to misunderstandings or hurt feelings. Family dynamics may shift as different members cope with grief in their own ways
• Parent-child relationships – the relationship between parents and surviving children may become strained as both struggle to navigate their grief. Parents may inadvertently withdraw emotionally or become overprotective, while children may feel misunderstood or unsupported.

Parental Coping Mechanisms

Every parent will find different ways to cope in the days, weeks, months and years after the loss of a child. It is important to understand that the pain will never completely go away, and you will never stop grieving; however, you can, in time and with the right support, learn to live with the loss. Some coping strategies that may help parents navigate their new reality include:

• Seeking support – it is essential for parents to seek support from family, friends, support groups, counsellors or other professionals who can provide comfort and understanding. Sharing thoughts and feelings with others who have experienced similar losses can be particularly helpful.
• Give yourself the opportunity to grieve – grieving is a natural and necessary process. Allow yourself to feel the full range of emotions that come with grief, whether it’s sadness, anger, guilt or despair. There is no right or wrong way to grieve, all of your feelings are valid and everyone’s journey through grief is unique. Being open about how you are feeling and the thoughts you are having is also helpful so that the people around you can offer support.
• Take care of yourself – it is important for parents to take care of themselves physically, emotionally and mentally during this time. This may involve getting enough rest, eating healthily, exercising and engaging in activities that bring some comfort and relaxation.
• Find meaning and purpose – many parents find comfort in finding meaning and purpose in their child’s life and legacy. This may involve creating a memorial, starting a charity or foundation in their child’s name, or participating in activities that honour their memory.
• Create rituals – rituals can provide comfort during times of grief. Creating rituals such as lighting candles, or celebrating their child’s birthday or other significant dates.
• Find healthy outlets to express your feelings – whether this is through journaling, writing, art, music or other creative activities. Expressing your emotions can be therapeutic and help you process your grief. It is also important to talk about how you are feeling with the people around you so that they know how you’re feeling at different stages and how they can support you through this.
• Try to be a team with your partner if you have one – the death of a child can put a lot of strain on relationships. You might find you are grieving differently from one another, finding comfort in different things, or going through different feelings at different times. Try to be understanding of each other. Everyone grieves in their own way and some people will need more time to process this than others.
• Practise self-compassion – be kind and gentle with yourself as you navigate through the grieving process. Understand that healing takes time and that it’s okay to have difficult emotions. Allow yourself to feel what you need to feel without judgement.
• Seek professional help if needed – if you find that your grief is overwhelming and interfering with your ability to function or cope, it may be helpful to seek professional help from a therapist or counsellor who specialises in grief and loss.
• Finding hope – this may be very difficult to think about at first; however, if possible, try to find some moments of hope and comfort. This could be through connecting with loved ones, finding solace in nature, or finding meaning in spiritual or religious beliefs.

Losing a child is unimaginable for anyone who has not experienced this and navigating such grief can be an incredibly isolating and overwhelming experience. In these times, community and peer support play a crucial role in helping parents to cope with their loss and begin the healing process. Connecting with people who have an understanding of your loss and can empathise is important.

Sibling Bereavement

Children who have lost their sibling may find the loss very difficult to understand. This will also depend upon their age and understanding at the time of their sibling’s death.

Children and adults often grieve differently due to various factors including cognitive development, emotional understanding and coping mechanisms. Young children might not grasp the permanence of death and may expect the deceased person to return. As they grow older, their understanding of death becomes more concrete.

Children may express their grief differently from adults. They may not have the vocabulary to articulate their feelings and may express grief through behaviour. Children may move in and out of grief more quickly, returning to play or other activities sooner than adults. However, this doesn’t mean they have fully processed or resolved their grief, and it is likely to resurface later.

Losing a sibling can be an incredibly challenging and painful experience for a child. Here are some ways you can support a child after the loss of their sibling:

• Encourage open communication – encourage the child to express their feelings openly and without judgement. Let them know that it’s okay to feel sad, angry, confused or any other emotion they may be experiencing.
• Listen actively – be present and attentive when the child wants to talk about their sibling or their feelings.
• Validate their feelings – let the child know that their feelings are normal and natural reactions to loss. Avoid dismissing or minimising their emotions, even if you don’t fully understand them.
• Provide reassurance – assure the child that they are loved and supported, and that it’s not their fault that their sibling passed away. Reassure them that they are not alone in their grief and that you are there for them.
• Maintain routine – try to maintain a sense of normalcy and routine in the child’s life as much as possible. This can provide stability and a sense of security during a time of upheaval.
• Offer opportunities for remembrance – encourage the child to share memories of their sibling and participate in activities that honour their memory, such as creating a scrapbook, planting a tree, or holding a memorial service.
• Seek professional help if needed – if the child is struggling to cope with their grief or showing signs of depression, anxiety or other mental health issues, consider seeking the help of a therapist or counsellor who specialises in grief counselling for children.
• Take care of yourself – supporting a grieving child can be very difficult, particularly if you are overwhelmed with grief yourself. You may need to ask other people to support your child as well.
• Do not be afraid to show your own emotions – it is ok to show children your own emotions as it teaches them that all emotions are ok and they do not need to push these down or hide their own emotions.
• Encourage peer support – if possible, encourage the child to connect with peers who have experienced similar losses. Support groups for children who have lost siblings can provide a sense of understanding and connection to other people.
• Be patient – grieving is a process that takes time, and the child may experience ups and downs along the way. Be patient and understanding as they navigate their grief journey.

Seeking Professional Help and Support

Seeking professional support to help you navigate through your grief may be helpful for some people. Especially after the loss of a child, the grieving process can be so complex that the only way forward is through seeking professional support. You can speak to your GP and get a referral for bereavement counselling through them.

There are several charities and organisations that can offer support to bereaved parents and family members.

Child Bereavement UK supports children, young people, parents and families to rebuild their lives when a child grieves or when a child dies.

Cruse Bereavement Support supports parents with peer support groups, local services and a helpline.

The Good Grief Trust provides support for parents whose child has died and provides details of support organisations near you on their UK map.

The Lullaby Trust raises awareness of sudden infant death syndrome (SIDS) and offers emotional support for parents.

Tommy’s is dedicated to finding causes and treatments to save babies’ lives as well as providing trusted pregnancy and baby loss information and support. They have a dedicated helpline where specialist Tommy’s Midwives support people who have had any type of pregnancy loss, including miscarriage, stillbirth, ectopic pregnancy, molar pregnancy or termination for medical reasons. You can call 0800 0147 800 or email midwife@tommys.org

Sands exists to reduce the number of babies dying and to support anyone affected by the death of a baby.

Conclusion: Navigating the Journey of Loss

Navigating the journey after the loss of a child is a deeply personal experience that no parent should have to endure. It is a journey marked by deep grief, unimaginable pain and complex emotions.

Through support networks, therapy, self-care practices, and honouring the memory of their child, parents can begin to navigate this difficult path. While the pain of losing a child may never go away, it is possible, in time, to find moments of peace and joy amidst the sorrow.

Each person’s journey is unique, and there is no right or wrong way to grieve. It is essential for parents to be gentle with themselves and allow themselves the time and space to heal in their own way.

If you know someone who has lost their baby or child, please continue to support them in any way you can. Sometimes you may not know what to say and it is ok to say that you are finding it hard to know what to say, but that you want to be there for them in whatever way they need. You can simply offer a safe space for them to express their feelings, allowing the grieving person to share their emotions without judgement. During times of grief, everyday tasks can become overwhelming. Friends and family often step in to provide practical support, such as cooking meals, running errands or helping with household chores, allowing the grieving person to focus on their emotional well-being.

Our thoughts are with anyone who has been affected by the death of a child, and we hope that this article can provide some guidance on navigating this painful journey.