In today’s issue

📖 Deep dive: The Forgotten Grievers: A Nurse's Guide to Supporting Siblings in Pregnancy Loss
🔗 The best links I found this week
🩷 Self-care moment: A lesson from Penny Reid

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📖 Deep Dive

The Forgotten Grievers: A Nurse's Guide to Supporting Siblings in Pregnancy Loss

As L&D nurses, you're often the first line of support for families experiencing pregnancy loss. You also see what parents go through when they are tasked with breaking the news to their children about the loss of their sibling.

The sibling involvement impacts the entire family's grieving journey and when siblings are included thoughtfully, it helps the whole family heal. This study by the NLM shows that 93.7% of mothers chose to involve siblings in the bereavement process, and the early moments matter deeply for long-term processing.

After reviewing multiple studies, clinical guidelines, and expert recommendations, here are evidence-based answers to the most common questions L&D nurses face when supporting siblings in pregnancy loss.

What should parents say when first telling their children?

Breaking this news is one of the hardest moments for parents and they might likely lean on you for support.

Simple, honest and clear language works best: "The baby has died and won't be coming home with us." For younger children, you might say, "The baby's body stopped working, and the doctors couldn't fix it."

Avoid vague phrases like "went to sleep" or "we lost the baby" - these can create new fears or confusion. Be prepared for questions like "Can we get another baby?" or "Did I make this happen?" The key is responding clearly and honestly: "No one did anything wrong. The doctors tried very hard to help."

How can siblings participate in saying goodbye?

The Child Life team at Yale New Haven Hospital suggests allowing children to lead their own goodbye process. Some may want to sing to the baby, others might draw pictures or write letters. Many children find comfort in giving their sibling a special toy or blanket. Research shows this autonomy in the farewell process helps children process their grief more effectively.

Here are some ideas to involve children to help them feel connected to their stillborn sibling.

• Helping choose a special outfit or blanket

• Decorating a memory box

• Recording a message or song

• Taking photos together

• Placing a special toy or drawing in the bassinet

Should siblings be encouraged to hold their stillborn brother/sister?

Create an environment where physical interaction can happen naturally. This could be a stillborn room Often, seeing parents hold and talk to the baby helps siblings feel comfortable approaching. Start small: "Would you like to touch their hand? See how peaceful they look? He/she has your nose”

Some siblings will want to hold the baby right away; others might prefer to just look. A 5-year-old might want to count fingers and toes, while a teenager might want to hold sister/brother. Follow their lead and validate whatever feels right to them.

The National Share Pregnancy Loss Support program emphasizes that holding should never be forced but should be gently encouraged if the child shows interest.

At what age should siblings visit the hospital?

There's no minimum age - it's more about preparation and support. For toddlers, keep visits brief (10-15 minutes) and have a familiar adult ready to take them if needed. School-age children often do well with longer visits and more involvement in memory-making. Teenagers might want multiple visits or private time. The key is preparing them beforehand: "The baby will feel cold" or "It's okay if you want to leave and come back."

What should nurses provide families for memory-making with siblings?

Think beyond just handprints and footprints. Some meaningful activities I've seen include:

• Making matching bracelets - one for baby, one for sibling

• Recording heartbeats before the loss to put in a special stuffed animal

• Creating hand molds of the whole family

• Making ink prints of siblings' hands next to baby's

• Taking photos of special moments, like a sibling reading to the baby

• National Share recommends having a child create their own memory box for their sibling

🔗 My Favorite Finds

💗 Heartbeat

Create a stuffed animal with baby's recorded heartbeat that siblings can keep close Source: (My Angel's Heartbeat Bear)

🎁 Memory boxes

Some of you may know that I started Forget Me Not a few years ago after experiencing my own loss. Partnering with my brother-in-law a CRNA, MS, we created an educational, modern, and beautifully designed bereavement box. Since then, we've continued to grow, doubling the number of boxes provided to hospitals each year, with about 80% of hospitals choosing to reorder. (Forget Me Not)

📚 Books 

"The Best Books for Parents Grieving the Loss of a Child" – A thoughtfully curated list to guide grieving parents toward comfort and understanding. (Gemma’s Hope)

🧒 Age appropriate guide

Comprehensive guide for age-appropriate language when discussing baby loss with children, created by loss parents. (Tommy's UK Pregnancy Loss Organization)

💡 Feedback

A nurse asked moms on Reddit "What could your nurse have better supported you through your loss?" The mom’s responses were insightful. (Reddit)

🩷 Self-care moment

"You are not required to set yourself on fire to keep others warm."

– Penny Reid

Remember to care for yourself as deeply as you care for others.