Siblings of deceased infants may need help coping

NEW YORK (Reuters Health) - The emotional impact on siblings of infants who die in the neonatal intensive care unit (ICU) can be substantial, often causing anxiety that lasts into adulthood, research suggests.

Researchers at Dartmouth Medical School in Hanover, New Hampshire, headed by Dr. Joanna H. Fanos, interviewed 14 siblings, 16 to 27 years of age, from 9 families of infants who died in the neonatal ICU.

They found that 11 of these individuals had high levels of anxiety and 7 had "repetitive nightmares signaling their preoccupation with death." Three individuals suffered from feelings of guilt.

Many reported that their parents had never appeared to mourn the loss or received significant emotional support. There was often an air of "family secrets" and "unfortunately, siblings seemed not to have discussed the topic with each other, but each struggled alone," the researchers wrote in The Journal of Pediatrics.

Fanos and colleagues also found that children who were alive when the infant was ill appreciated any involvement they were allowed to have, such as holding or talking to the infant or bringing gifts. Rituals after the death opened doors to communication, and photos and memorabilia became treasured objects.

Fanos and colleagues think doctors "should allow siblings to be active participants in the infant's brief life and death." Furthermore, "medical providers and family members alike should consider psychological counseling to gain insight into the emotional responses to death in the neonatal ICU."

SOURCE: The Journal of Pediatrics, online April 2, 2009.