by David J. Schonfeld, MD, FAAP and Arwa Nasir, MBBS, MSc, MPH, FAAP, American Academy of Pediatrics

Credit: Unsplash/CC0 Public Domain

Death creates a deep, lifelong impact for kids in every part of the world. In the United States, around one in 20 children will lose a parent by age 16—and countless others will grieve for a grandparent, sibling or someone else they love.

Doctors who treat children and teens know the health impact that serious losses like these can have on their health and development. In a busy practice, pediatricians see at least one child per week who may be grieving the death of a relative or friend. Here's what to know when your child is mourning a loved one—and how your pediatrician can help.

Grief is the pain we experience after losing something or someone we love. Although people grieve many kinds of loss or separation, grief is often linked with the pain that follows the death of someone close to them.

Children of all ages may mourn the loss of someone whether they were family or not. Neighbors, friends, teachers, coaches, caregivers and others they loved or cared about may touch off a time of mourning.

Grief can cause disbelief, denial, confusion, anger, anxiety and deep longing for a loved one to come back. These emotions can affect a child's physical health, since they can interfere with healthy sleep, regular meals and more. Losses that feel overwhelming can also fuel anxiety, depression, self-harm and thoughts of suicide in children and teens.

It's helpful to realize that other forms of loss can create grief, too. For example, kids who desperately miss a divorced parent they no longer live with, or whose close family members are in jail or prison, may feel the loss very deeply. Others whose parents have been deported or moved away for work opportunities may suffer, too.

Whatever your child's history or circumstances, keep in mind they won't simply "get over" a loved one's death within a few months or even a year. They will spend the rest of their lives dealing with the loss. Future milestones such as graduating from high school or college, moving to a new home, falling in love or becoming parents themselves can throw "adult children" who lost someone dear to them temporarily off-course, even decades later.

Though you can't erase the pain your child feels, there are many ways to help them deal with their grief. Here are some steps that you can take now to protect their health and enable them to navigate grief and loss better as adults:

Many children and teens need focused support in processing grief. Watch for signs of major changes in your child's approach to everyday life. For example, you might be concerned if a child who loves to tell stories becomes unusually quiet, responding to questions with one- or two-word answers. Or if a teen who's known for being a "take-charge" person struggles to make choices or manage time effectively. Be alert if your once-gentle preschooler begins to hit, push or shout at classmates or teachers.

If you are concerned, call your doctor. Pediatricians and family physicians care about the well-being of your child's body and mind. They can screen for specific concerns and talk privately with kids who feel reluctant to speak in front of others. They can also refer you for grief counseling and community programs such as support groups and camps for kids grieving a serious loss.

Talk with teachers, school mental health professionals, coaches and other support people. Grief can interfere with school, sports, youth groups and other mainstays of your child's life.

While you want to respect your child's privacy, it's helpful to let teachers, counselors, coaches and youth group leaders know what's happening.

For older kids, ask their permission and explain why sharing this information with these caring adults is helpful; it lets them see your child with compassion, provide learning supports and accommodations, develop plans for addressing grief triggers in class or other groups settings, and share programs and resources that can help your family.

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