by Khris Ford, MA, LPC
Pregnancy and birthing, bringing home baby and taking care of baby are all a part of the family affair we call “becoming a family.” Siblings often get to help with picking a name, painting the nursery and many other activities that are a part of the transition through which a family passes as a new member is ushered into the world. Yet so often when the pregnancy and the birthing experience don’t happen as planned, the “family” gets lost in the midst of decisions that lead to more decisions, emotional adjustment processes, and the day-to-day business of survival and crisis management. Siblings who were once a part of this wonderful chapter in their family life cycle often find themselves on the outside trying to look in and understand what is happening.
Emotional Needs of Siblings
The fact is, even young children have important emotional needs that need to be met. While these healthy siblings may have their physical needs addressed by a loving family member or friend, their emotional and psychological needs are often misunderstood or simply missed as critical days and even weeks in the neonatal intensive care unit go by. Munch and Levick explain, “Children have the same feelings as adults. They may experience emotional responses such as sadness, anger, guilt, jealousy, excitement, fear, impatience, confusion, worry and abandonment.”1 Real-life case stories from their article that studies sibling adjustment in the NICU reveal children’s responses:
Julie – Age 8 – “I worry that Jon (her brother) might die and I worried when my dad told me my mom had to stay in the hospital. I cried enough tears to fill two cups.”
Bobby – Age 5 – “I worry when my mom says she will be gone for a minute and its longer than a minute, that Jessica (his sister) will get sick, that my mom will not come home until 12:30 midnight.”
So, how in the midst of such a stressful and difficult time does a family find the time and energy to give all of their children what they need? There are three primary keys to attending to the needs of the whole family: communication, care assistance and community.
First, and perhaps the most important key to meeting the needs of the whole family is to establish high-quality, frequent communication with siblings. That is, children who have a sibling who is in the hospital or having ongoing treatments of any kind need to be informed at a developmentally appropriate level of what is happening to their brother or sister. When an infant is born prematurely the sibling needs accurate and truthful information about what has happened. It is normal for parents to want to protect their children from this kind of information. However, in reality, information helps children in the family to have a sense that they are trusted, that the parent believes they can handle the situation, and the child will feel a greater sense of control over what is happening around them. Communicating what is wrong with the baby, what doctors are trying to do and any plans for treatment draws the child into the family circle rather than feeling as if they are on the outside of what is happening. At times it may even be helpful for a sibling to be a part of a discussion about treatment decisions, at least to the extent that they are able to express their opinions and feelings. In the absence of communication, children will make up their own explanations and may assume things are much worse than they are or that they are somehow at fault for what has happened.
Secondly, find ways your sibling can participate in the care of their baby sister or brother. These experiences can be some of the most empowering experiences a sibling can have as your preemie or child with special needs moves through those first weeks and months. Obviously what the sibling can do is greatly dependent upon the circumstances of your baby’s medical condition. However even being able to pack the bag of things that mom or dad takes to the hospital each day is a way of being a part of the care. Perhaps the sibling draws a picture or sends a special toy or blanket to the hospital for the baby. Recording the sibling as they tell a story or sing a song that is taken to the hospital for the baby is a very special way for the sibling to be a part of the caring. Be creative with this as almost any act of love will give your sibling a role in the care of his or her brother or sister.
Lastly, community is an essential aspect of the challenge of meeting the needs of all the family. Siblings need to know that the roles filled by mom and dad are going to be taken care of by someone. Allow neighbors and family to be the healing community needed at this time in the life of the family. The Zinda Family who has siblings with different needs shares these thoughts, “In a NICU situation a family can use all the support available! Siblings can sometimes feel overlooked or less important since the daily activities and conversations revolve around the NICU baby. Therefore, if siblings are given extra attention or treats from others, they feel important and it makes this stressful situation easier for them.”
Let your child in on the plan for helping get his/her needs met. Create a calendar so that your child knows who in their healing community will be taking them to scouts, making their lunch for school or making sure they get to their classmate’s birthday party. Again, remember that communication is key. Talk to your child about the plans. Perhaps even get their input on who does what to help them. These critical conversations will give your healthy child the support and structure they need to thrive during this very stressful time.
Any time a new child is added to the family, the birth, whether routine or not, is a family affair – one in which everyone has a stake and will be impacted. Offer the older children in your family the opportunity to help shoulder a small portion of what is happening – a measure that is appropriate for their age. They will be rewarded with a greater sense of control, trust, and strength in their family and learn that their family is a place where difficulties can be embraced and overcome through love.
Source: 1 Munch, S., Levick, J. (2010). “I’m special too.” Promoting sibling adjustment in the neonatal intensive care unit. Health and Social Work 26(1). 58-64.
Khris Ford, MA, LPC, is the Executive Director of My Healing Place, a nonprofit grief, loss and trauma counseling practice which offers support groups, individual and family therapy, training and consultation, and information and referral. She is also an adjunct professor at the University of Texas at Austin School of Social Work where she teaches graduate level courses in grief and loss counseling. She is also a bereaved parent, and it is her personal experience of transformative grief following the death of her son, Stephen, in 1989 that fuels her passion for work in the field of grief, loss and trauma. She holds dual Master’s degrees in elementary education and counselor education.