What about the Siblings?

What about the Siblings?

Fanos JH, Little GA, Edwards WH. Candles in the snow: Ritual and memory for siblings of infants who died in the intensive care nursery. J Pediatr 2009;154:849-53. Abstract | Full Text | Full-Text PDF (203 KB)

Objective: To assess the developmental impact of surviving a sibling who dies in the neonatal intensive care unit (NICU). STUDY DESIGN: Fourteen (13 adults, 1 adolescent) siblings of infants who died in Dartmouth-Hitchcock Medical Center's NICU between 1980 and 1990 were interviewed. The interviews were recorded and transcribed verbatim, and prominent themes were coded.

Results: Six siblings rated family communication as veiled or a family secret; 7 reported unresolved parental mourning. Eleven siblings were rated high on anxiety themes, including concerns over future pregnancy or anxiety about their mother's health. Photos and family rituals were helpful to siblings in grieving and remembering the infant.

Conclusions: Although death in the NICU often has a brief course, consequences for survivor siblings can be life-long. Siblings born both before and after the death of an infant may be at risk and in need of psychological support. Family rituals and photos are important vehicles of communication, grieving, and memory for siblings and parents alike. Clinicians should allow siblings to be active participants in the infant's brief life and death.

Comments: Although these authors were only able to interview a small number of siblings of infants who had died in the NICU, their stories are very revealing and I encourage the readers of NeoNotes to take the time to read the entire paper with the original quotes. This paper made me feel guilty for I probably have not paid enough attention to siblings of infants who died in my NICU. Did you? TMB.

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