Neonatal death: grieving families.

This paper examines the stress on a family after a neonatal death. Sixty-seven families who experienced 63 neonatal deaths and four post-neonatal deaths were studied during an interview held eight weeks after the death. Predominant support for the parents was provided by each other (63%), their parents (33%), friends, many of whom had experienced a similar loss (16%), neighbours (15%) and religion (13%). Grief reactions were more commonly reported by mothers than by fathers and included: sleep disturbances (51%); depression or fits of crying (34%); anorexia or weight loss (33%); nervousness and anxiety (19%); social withdrawal (18%); morbid preoccupation (9%); and guilt, anger or hostility (9%). Grief reactions were graded on a scale of I (physically, psychologically and emotionally settled) to IV (serious symptoms that disturbed day-to-day functioning). Pathological grief reactions occurred in 21 families and correlated with a lack of parental support and contact with their critically ill infant and a severe initial grief state (P less than 0.05). There was no correlation with the type of initial grief reaction; the attachment to the baby; the age of the baby; the comprehension of the cause of death; the hospital care or the way that they were informed of the death. The loss of a newborn infant had a major pathological effect on 31% of the families that were studied. This was probably an underestimate as eight weeks is too soon to assess unresolved grief.