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    Grief, Bereavement, and Coping With Loss (PDQ®): Supportive care - Patient Information [NCI] - Children and Grief

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    Children at different stages of development have different understandings of death and the events near death.

    Infants

    Infants do not recognize death, but feelings of loss and separation are part of developing an awareness of death. Children who have been separated from their mother may be sluggish and quiet, may not respond to a smile or a coo, may have physical symptoms (such as weight loss), and may sleep less.

    Age 2-3 years

    Children at this age often confuse death with sleep and may feel anxiety as early as age 3. They may stop talking and appear to feel overall distress.

    Age 3-6 years

    At this age children see death as a kind of sleep; the person is alive, but only in a limited way. The child cannot fully separate death from life. Children may think that the person is still living, even though he or she might have been buried. The child may ask questions about the deceased (for example, how does the deceased eat, go to the toilet, breathe, or play?). Young children know that death is physical, but think it is not final.

    The child's understanding of death may involve "magical thinking". For example, the child may think that his or her thoughts can cause another person to become sick or die.

    Grieving children under 5 may have trouble eating, sleeping, and controlling the bladder and bowel.

    Age 6-9 years

    Children at this age are often very curious about death, and may ask questions about what happens to the body when it dies. Death is thought of as a person or spirit separate from the person who was alive, such as a skeleton, ghost, angel, or bogeyman. They may see death as final and scary but as something that happens mostly to old people (and not to themselves).

    Grieving children can become afraid of school, have learning problems, show antisocial or aggressive behavior, or become overly worried about their own health and complain of imaginary symptoms. Children this age may either withdraw from others or become too attached and clingy.

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