Supporting bereaved children under 5 years of age

It is now well recognized that very young children, including babies, do experience grief, they just show it differently. When someone familiar dies, the overriding response in the under 5s is a sense of loss. Being too young to understand the cause, and lacking the vocabulary, they express their distress through their behavior. Even a very young baby, with clearly no concept of what being dead means, will pick up on an emotionally charged atmosphere and will probably have a reaction of some sort. When it is a parent or main carer who has died, this loss will be particularly acutely felt through the inevitable changes such as an upset routine, a different carer, and unfamiliar surroundings with strange sounds and smells. A toddler is capable of taking in much more than most adults realize and will be very aware that something significant has happened. Under 5s can, and often do, react strongly to their own grief, but also to the grief of significant adults involved in their day-to-day care.Whatever the circumstances, babies and children under five years of age need to have their grief acknowledged, and their distress comforted.

How do babies and very young children understand death? Babies and Toddlers

Long before they can talk, babies are likely to react to the grief of a main caregiver and to the changes in their environment as a result of a death. At this age, there will be no understanding of what death and dying means, but there will be a sense of someone important missing. The resultant feeling of abandonment may create more than usual clingy behavior. With little or no language to express themselves, their anxiety and insecurity may show itself with inconsolable crying. Feeding and sleeping routines may be disrupted and their distress expressed by being generally miserable.

Toddlers to 5 years of age

Understanding will be increasing, but so will the need for information to try to make some sense of what has happened, resulting in lots of questions. Anxieties about everyday practicalities are common as is increased separation anxiety, even when left for short periods. Children at this age can use the words ‘alive’ and ‘dead’ but cannot understand the permanence of death and will have an expectation of the person returning, with consequent disappointment and sadness. They may struggle with the concept of ‘no life’ and may, therefore, need reassurance that dead people feel nothing and are not in pain.

Even very young children need explanation and information

When someone dies, adults often, with the best of intentions, do not tell children the truth, assuming that under 5s are too young to be aware, or understand. Particularly at this very young age, we feel that by talking about something that many adults struggle with, we are robbing them of their innocence and their childhood. However, without information, or using words suitable for their age, children cannot start to make some sense of what has happened. Without this, they may go through life minus an explicit memory of the death, but with a strong sense of a significant loss from which they have been excluded.
Do not be afraid to use the word ‘dead.’ It may feel harsh but ‘lost’ or ‘gone away’ only create confusion and misunderstanding in young children who take what they hear very much at face value. As with older children, the explanation may need to be repeated many times, but for this age group even more so.

How very young children might respond

All of the responses below are normal and are just ways that a very young child expresses their grief. Some will show all of these behaviors and others only a few, or none at all. It may be days or weeks before there is a reaction. Young children ‘puddle-jump’ in and out of their grief and move quickly between real sadness and normal activities. Because they cannot sustain powerful emotions for any length of time, puddle-jumping acts as a kind of safety valve and it does not mean that the child is unaffected.

Searching Behavior

Before they are a year old, children are beginning to understand the permanence of objects and people. If a main caregiver dies, the child will search for that person, expecting them to return. When that person does not appear, the child is likely to protest with behavior such as crying. Searching behavior is a common response in very young children.
Regression, behaving as if a younger child The need to be babied is an attempt to return to a time of feeling safe and secure, and it is also less stressful for the child to behave as if younger. Try to resist giving any impression that, after what has happened, the child is expected to act as more grown up. If you can, be tolerant and don’t make a fuss; being treated and comforted as you would a younger child, or baby, may be what they need.

Increased separation anxiety

Becoming aware that someone is missing creates fear in a young child. Try to give lots of physical reassurance with hugs and touch. Babies may need to be in almost constant physical contact with a trusted carer and will cry as soon as put down. Some children will need to remain physically close to an adult they know and may be extra clingy. Toddlers can sometimes be comforted by an object such as a blanket or jumper which has a familiar smell. Leaving a photograph or something of yours to ‘look after’ can also help. When you do have to leave them, it will help if you explain where you are going. Always say when you are returning with a time the child can relate to. Something to look forward to might help: ‘Mummy is going to work now, but I will be back at tea time when we can read your favorite book.’

Tantrums and Anger

All children tend to express themselves through behaviors rather than words but this is, even more, the case with the under 5s. Having too immature a thought process to make sense of what has happened can add to the feeling of something being not right, but not understanding what. Frustration at a lack of words to express thoughts and feelings may come out as destructive behavior. Try to accept that this behavior is what the child needs to do rather than what they want to do. There will be times when they are completely overwhelmed by powerful feelings and may need to express them in a very physical way. They are allowed to be angry, but not to hurt themselves or others, so help them to find safe ways to do this. Maintaining your usual boundaries around acceptable behavior will give security to a grieving toddler whose world has been turned upside down.

Sleep disturbance

When grieving, it is common for very young children and babies to cry more than usual at bedtime and to need reassurance on waking through the night. At bedtime, they may not want to be left alone or may become anxious of the dark. Climbing into a parent’s bed at night may be a sign that they are having frightening dreams or are just generally fearful. Try to keep to the usual bedtime routines, but recognize they may need someone to stay with them until asleep. The need for this extra reassurance at bedtime should reduce once they become less anxious and their confidence returns. Sometimes using a dream-catcher or something similar might help a child to control night fears.

Withdrawal and being subdued

After a death, there is often a lot of coming and going at home and some young children can find it all overwhelming. Sometimes they react by retreating into themselves. They may lose interest in toys and people previously enjoyed. Allow them to ‘just be’ rather than cajoling them to cheer up. They probably will engage when ready to do so.
How you can help
Acknowledge what has happened. As has been said earlier, the most helpful thing that you can do for grieving children, even when very young, is to acknowledge what has happened and give them an explanation. Children not old enough to talk will still pick up on what adults are saying but be confused and frightened by the bits they do not understand. Keep it very simple: ‘Grandpa has died and this means that we will not see him again. We are all feeling very sad and will miss him.’ If the child attends a nursery or pre-school, staff there need to acknowledge to the child what has happened. Again, keep it simple, ‘I was very sorry to hear that your Mummy has died, that is a very sad thing to have happened.

Don’t assume that they understand what has been said. Try to check their understanding of what being dead means. Using some of the story books suggested at the end of this sheet, or exploring the life cycle with examples from the natural world, may help a toddler to start to grasp the reality of what being dead means.Try to answer questions honestly, Keep the language simple and age appropriate. If the child attends a nursery or other type of day care, it is important to let them know what has been said at home. It will confuse a very young child if explanations differ.

Adults act as a role model

It is helpful if everyone can take the same approach. Whether at home or in day care, children need an accepting and supportive environment where they feel safe to ask questions and share feelings. If the adults around them can express their emotions, young children will know it is OK to do the same.

Encourage and help them to express feelings

Very young children use play to help them understand what has happened. With adult help, model figures or glove puppets can be used to re-enact scenes, such as at a hospital. They may play at being dead. Adults watching might find this disturbing but it is how very young children make sense of the world around them. Messy painting or drawing can help a child who is too young to have acquired the vocabulary of loss and grief.

Be prepared to repeat explanations and information.

What they understood as a two-year-old will be different from their understanding at age three and at various other stages in their development. The meaning and the impact of what has happened will change and deepen. Questions asked previously may be asked again, in response to their need for more detailed explanations.

Give reassurance

When someone close to them dies, the world can become a very scary place for a young child, and they may start to wonder who else is going to leave them. If you make a promise, stick to it. Try to pick them up on time from nursery, for example, and give lots of reassurance that others are not going to leave.

When Someone Special Dies

Supporting Bereaved Children and Young People

For Professionals

When a child or family grieves

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