Unexpected death of an infant sibling

When infants die suddenly and unexpectedly, family structures are abruptly altered. This loss and its subsequent changes affect remaining older siblings. New "big brother" and "big sister" roles are suddenly terminated, often in a catastrophic manner. Young surviving children are sometimes unable to understand the meaning of this event, its impact on the family, and their own role in what has occurred. In this study, 26 families that had sustained the sudden and unexpected death of an infant and that had surviving children were interviewed to obtain data about surviving siblings at least 10 months following the loss. Among the 26 families, there were 35 surviving siblings (ages 16 months to 6 years). The interview schedule sought information relevant to changes in patterns of sleep, toilet training, feeding habits, peer relationships, and parent-child interaction. Among these 35 surviving siblings, parents of 28 siblings (80%) perceived changes in their child's interaction with them, 24 siblings (69%) demonstrated changes in sleep patterns following the baby's death, and 13 siblings (37%) showed changes in social interaction. Regression in toilet training and changes in feeding patterns were infrequent and not areas of major concern for parents. These behavioral changes reflected both a continuum of adjustment by the child and a persistence of parental worries.