Supporting siblings when a sibling is sick –


When their daughter, Lyla, was hospitalized at the age of 3 for spinal surgery and pancreatitis, John and Allison Mason soon realized that her twin sister needed some extra attention too.

“The experience was very stressful for Elliana,” said John Mason. “The girls had never spent a single day apart since leaving the neonatal intensive care unit as babies.”

The Lancaster family received help from Penn State Health Children’s Hospital’s Child Life program, which provides support for siblings of children who are hospitalized or have chronic illnesses.

“Child Life walked us through what to tell Elliana at home so she could understand Lyla’s situation in terms a toddler could understand, including why Lyla wasn’t home. school or why I slept in the hospital every night,” John Mason said.

When Elliana visited the hospital, she was invited to participate in the same activities as Lyla – from music therapy to hospital bingo to a special event with Penn State football players.

It has helped Elliana feel less scared and even have a little fun with her sister, despite her being in the hospital, her parents said.

“When a child is sick or hospitalized, it affects the whole family,” said Lindsey Reynolds, a board-certified child life specialist at Children’s Hospital. “Routines change and there’s a whole range of emotions.”


A sibling may worry about their sibling, especially if they look sick or are confined to a hospital bed, or think they have done something that caused disease. Siblings might also feel jealous of the extra attention the sick child is getting and wish they could be sick too, Reynolds said.

Parents may feel guilty for having to focus all their energy and attention on their sick child, leaving less time for other children and activities.

Parents are stressed and can show it – which may surprise their other children, who may have never seen their parents anything but in control.

“Children are very intuitive to the emotions of others and they can sense caregiver anxiety,” Reynolds said. “Siblings may be anxious about what they see and they may wonder who will take care of them when their carers are in hospital. When children have unanswered questions or don’t understand what’s wrong, it’s a place of great uncertainty.


To help, Child Life offers parents age-appropriate advice and resources, as well as individualized teaching sessions, books and playtime to help siblings cope.

“Often children don’t have the words to describe what they are feeling. We emphasize the importance of play — it’s the language of children,” Reynolds said. “Letting them play with a stuffed animal with similar medical equipment to their sibling can help them know what to expect before seeing their sibling for the first time.”

Child Life also offers SibShops, currently on hiatus due to COVID-19, which are free quarterly workshops that provide siblings with a safe space to meet other children who have sick siblings, talk freely about what they feel and have fun.

Here are some tips for parents to make the most of the unexpected situation.

  • Be honest. Give concrete information about your child’s illness. Otherwise, siblings might overhear bits and create a bad narrative in their minds.
  • Use proper nouns. Calling cancer “the C-word,” for example, might make it seem mysterious and raise fear.
  • Make a game plan. Share the medical plan to help your sick child and the new routine for your other children, including who will help care for them when you are in the hospital.
  • Give back some control. Discuss with your children what to expect when they visit the hospital and let them decide if they want to go or not. If not, ask him if he’d like to send favorite family photos or drawings or take advantage of technology that allows you to share a bedtime story remotely.

Throughout the journey, Reynolds suggests parents create intentional space for emotions – those of their children and their own.

“Instinctively, parents and caregivers want to be brave and protective, but it’s important for them to identify their emotions and admit they’re also scared,” Reynolds said. “It’s good to shed a tear together too.”


Although most siblings survive the situation with support, some children may need additional help from a therapist or doctor. Changes in eating or sleeping habits and increased emotional behavior – isolating oneself from others, becoming very clingy, throwing temper tantrums – could be normal reactions to the stressful situation; however, families know their child best and should contact their child’s healthcare provider for ongoing support and concerns, Reynolds said.

Maintaining a sense of family unity goes a long way to making siblings feel safe, Reynolds said.

“Emphasize that even though a sibling may be in a different place or look or speak a little differently right now, they are still part of our family, and we can still find ways to play. and connect like we always have,” she says.


The Medical Minute is a weekly health report produced by Penn State Health. Articles feature the expertise of faculty, physicians and staff, and are designed to offer relevant and timely health information of interest to a broad audience.

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