Ages 0-2

Concept of death

Infants and toddlers do not understand the concept or permanence of death. However, they do know when a sad event like a severe illness (“very, very sick”), injury or death has happened in their family and feel the stress of separation. For a child of this young age, the stress they experience can relate to the loss of a loved one, but it also may relate to changes the child experiences in their own daily life as their familiar caregiver(s) may be less available during this difficult time as they focus on caring for the ailing family member (their own parent, spouse, etc.) or on managing their own grief.

Ways they show stress

• Crying, moodiness (fussier than normal)
• Changes in sleep habits (sleeping more or less)
• Changes in eating habits (eating more or less)
• Increased need for physical closeness (wanting to be held more often, getting upset when caregiver leaves room, etc.)
• Regressive behaviors (returning to bedwetting, bottle, baby talk and baby toys)
• Increased aggressive behavior/acting out (biting, pushing, etc.)

Ways they cope

• Increased use of pacifier, favorite blanket and other comfort items
• May become fussier and want to be held constantly
• May become overly attached to one caregiver and not want to be left with others
• How to talk to them
• Use simple, concrete words to explain what’s happened (“Grammy has died. That means she is not coming back.”)
• Avoid vague statements such as “Grammy went bye-bye” to avoid confusion between a temporary absence and a permanent one
• Be patient when the child asks for their loved one and be prepared for multiple conversations in which you reinforce the permanence of death

How to provide support

• Allow and encourage use of comfort items (pacifier, stuffed animal, blanket, etc.)
• Recognize they may need more physical comforting and reassurance
• Do not punish them for any regressive behavior
• Acknowledge their feelings and give words to how they may be feeling ("I know you must feel scared and sad that Daddy died, but I am here to keep you safe and I love you.")

Activities to help with coping

• Maintain child’s usual routines (their regular bedtimes, bath times, mealtimes, etc.) with consistent and familiar caregivers
• Allow tears and provide comfort (cuddling, rocking, reassuring talk)
• Allow child to choose, and keep, a familiar article of clothing or pillowcase of the loved one who died (familiar scents can be comforting)
• Allow child to choose, and keep, a favorite photograph of the loved one
• Share stories and memories of the loved one