Coping with Neonatal Death

Archived Q&A and Reviews



Post-stillbirth grief counselor

Jan 2008

I lost a baby at 20 weeks a year ago and am having major fears about trying to have another child because the grief was so severe. I have been blessed with one healthy child, but the unexplained loss that I had has made trying to conceive again very stressful. Can anyone recommend a counselor - preferably in SF, but I would go anywhere to see the right person -- who has addressed these multiple issues? Thanks so much. Anon

First, I want to say I am very sorry for your loss. I had a stillbirth 3 years ago this month and have not had children before or since due to fertility issues despite my being under 30. I can recommended a therapist by the name of Donna Rothert . She facilitated a support group on pregnancy loss and also saw patients individually. I saw her in both capacities over the course of 10 months in 2006-07. She has offices in Oakland's Rockridge district and in Walnut Creek though I only saw her in Oakland because I'm on this side of the hills. She is very knowledgeable on infant loss, miscarriage and stillbirth. More than anyone I have ever seen. Grieving Mama

The therapists at Perinatal Psychotherapy Services (Donna Rothert, Gina Hassan, and Lee Safran) are wonderful. They deal with pregnancy loss issues all the time. They are in Berkeley, and may be worth the trip, or they may know excellent people in SF. Good luck. You're not alone.

I am sorry for your loss. Having gone through a stillbirth and 2 subsequent pregnancies, I totally recommend counseling to support you through the process. I saw Kim Kluger-Bell . She is warm, understanding and knowledgeable. She has written a book about pregnancy loss and is well known in the field. She is in Berkeley on Solano Ave. I wish you peace on your journey. Been There Too

I'm so sorry for your loss. I missed your original post, so I don't know if you have heard of Support After Neonatal Death (SAND) , a support group run through Alta Bates Hospital. I started going to SAND in 1982, close to a year after losing my first child to premature birth and several months after starting work with a grief counselor. I didn't go earlier because I couldn't imagine that hearing many different stories about losing a baby would make me feel better, especially since I was having trouble conceiving again. However, SAND proved to be invaluable in my emotional recovery from the loss and subsequent infertility. First, I met women with similar stories which helped me set aside ''what if.'' (What if he had been a girl, what if I were of a different ethnic category, what if I had gone to the doctor sooner, what if he had received treatment at a different hospital...We were all at risk.) I was encouraged by the women going through successful 2nd (or 3rd or more) pregnancies. I received incredible support for moving on--through adoption and (10 years later) a birth as well. I went to SAND regularly for about 2 years. According to the website, SAND meets from 7:00 to 9:00 pm on the first and third Wednesdays of each month at 3030 Telegraph Ave. (at Webster St.) in Berkeley. It is free and registration is not required. For more information, call (510) 204-1571. I wish you the best in finding the help you need and in growing your family. Sympathetic mom

Brother lost his preemie twins

Sept 2005

Today I got the news that my younger brother and his wife were about to lose their preemie twin. He was born at 29 weeks after his twin died in utero and my sister-in-law went into premature labor. The live twin seemed ok for about a week, but then the doctors (down in LA at Children's Hospital, which is supposed to have the best neo-natal care in the country) discovered that his kidneys were in ruinous shape and that he may have brain damage and in any case, was unlikely to live. My brother and sister-in-law made the decision to unhook Baby Tak (Max Takeshi) and hold him until he passed. This was their second pregnancy. The first one ended early in miscarriage. David is 37 and Hiromi-chan is 32. This has been a devastating experience for the whole family. I, the eldest daughter, with two healthy kids of my own, don't know what to say or do. Can anyone on this list suggest a way I can help them through this, in any small way? Recommend a good book for dealing with grief of this kind? Point me to a website with wisdom and advice? I'm flailing here. And I want so badly to ease their pain, if only just a little. Thanks for any advice. Julie

Dear Julie : I am so sorry to hear of your brother and sister- in-law's loss. I would like to recommend you going to the web site for the National Organization of parents of twins club for griving support. I run an organization called Twins by the Bay (bay area) and we often refer parents to them after the loss of one or both twins. The web site is Please feel free to contact me directly if you wish more information. Susie

Realize there are some things in life that don't need your help. You have no experience to help with your brother's family grief. You can tell him how you feel, however, the one thing you do know. Tell him that you want so badly to ease their pain, but know you can't. Nothing more.

Dear Julie,

I'm so sorry to read about your brother and his wife's loss of their preemie twins. The pain of birth/death is almost unbearable -- I lost my second son Thomas a few days after his birth, but eventually, through the grieving process, it is possible to come to a peaceful place. In this difficult time, being there for them in any way you can will be a tremendous help.

And here are a few useful books: ''When Hello Means Goodbye'' (available from Perintal Loss, 2116 N.E. 18th Ave, Portland, OR 97212) tel: (503) 284 7426

''Dear Cheyenne'' (available from Mothers in Sympathy and Support, 8448 W. Aster Dr, Peoria, AZ 85381) tel: 602 979 1000

''Sylvie's Life'' Marianne Rogoff 1995 (published Zenobia Press PO Box 5212 Berkeley, CA 94705

''Empty Cradle, Broken Heart -- Surviving the death of your baby'' Deborah Davis Ph.D. Fulcrum Publishing 1996

''I wish I could hold your hand'' -- a child's guide to grief and loss Dr. Pat Palmer Litle Imp Books

And there are groups called ''Compassionate Friends''

And here are a bunch of links that offer support:

Sending warmth and compassion to you and your family, Katy

I am so sorry to hear about your brother's loss. Something similar happened to some friends of mine and I think the approach they chose may have eased their burden a little. First of all they thought of themselves as parents who had lost their babies (also twins) rather than as people who had lost a pregnancy. They also were able to hold their babies for about 24 hours. They named their babies and shared those names with their friends and family. Then a few months later at around the time of the babies' due date they had a memorial for them with friends and family.

At that time several people shared that they had also lost babies during pregnancy, and those people who treated the event as a ''miscarriage'' rather than the loss of a child said that they hadn't allowed themselves to properly grieve. I don't know what you can do, but I do know that treating it as losing children rather than a pregnancy will help you avoid saying things that are unintentionally hurful (i.e. one would not comfort someone who had lost a child by saying that they could have more children.) I don't think that there is anything anyone can say or do to ease their pain. Only time can do that. But I'm sure that they will appreciate your loving support. --wishing you all comfort and peace

My husband and I lost our first children, twin girls, at birth. I had to deliver prematurely because of life threatening pre-eclampsia. My baby's lungs were not sufficiently developed, and they both died about 1 1/2 hours after delivery.

The grief of loosing a baby is beyond devastating. Some discribe it as a form of insanity and it was that way for me. At one point I latched on to the idea that if I'd only eaten more eggs during my pregnancy that none of it would have happened. Sounds crazy now, but I truely believed it at the time.

I also went through a period where I felt that I had subconciously killed my babies. That my body had rejected them and caused their deaths. The guilt was crushing. I considered suicide. The thought of it was seductive. The only thing that stopped me was the realization that with both my parents still alive, that I would be transferring all my pain onto them. They and my husband would go through even more grief.

I also realized that given my recreational drug use history, and my family's history of alcohol abuse, that I needed to go through the grief process straight and stone cold sober. I knew that if I began medicating my pain that I would spiral down into a hole that I would not be able to get out of.

Your brother and his wife may experience similar crisises. Since they lost their first pregnancy too, they could experience even more complicated grief.

As to what you can do, here's what I found helpful and not. I needed to talk and not hear placating responses, even though people were trying to be supportive. Sentences like, ''you'll get over it'', or ''you'll be able to try again'' or the worst ''they're with god now'' were horrible. To be supportive, say something like, ''I wish there was something that I could do to ease your pain''.

What was critically important for me was joining a neonatal loss support group. Many hospitals offer such programs. We also sent out an announcement card, to let everyone know that we suffered the loss. I dreaded the idea of bumping into people and having them exclaim happily, ''how are the babies?''.

There are some good books on the subject too. I think the one I liked was called, ''Surviving Neonatal Loss''. The best advise I received was this; do not make any life changing decision, like moving, changing careers, divorce, etc. for at least one year afterward.

The statistics on divorce after neonatal death are pretty grim. Everyone grieves differently, and grief is more likely to tear a marriage apart then bring it together. But if both parents realize this, then it can be something that they work to acitvely avoid.

Keep in contact with both your brother and sister in law. Call often, just to check in. If they live in the area, visit them. Allow them to spill their guts if they want to. Or not say so much either. Bring prepared dinners, like a big plate of lasagna, so they don't have to cook. Do laundry, clean the house, cut the grass. The minutia of everyday life is overwhelming when you're grieving. Don't wait to be asked. If you see dirty dishes, clean them.

Go for walks with them. With grief comes extreme lethargy. Getting the blood flowing is always a good idea.

If they have a nursery set up, volunteer to help them put things away when they feel ready. Some might want to get rid of everything right away, so they don't have to be reminded of the loss every time they look around. Others will need to hold onto what they have, because it's all they've got left.

My husband and I decided to make a memorial box, and in it we placed several special keepsakes for each baby, which we have to this day. I visited the box often in the months afterward.

We also had a small, private goodbye ceremony with just closest family members. We found a double Redwood tree and placed their ashes at the base of the tree and said our goodbyes. It was comforting for us to visit the tree on our hikes. We're not religious, so it helped with closure.

It's also important to keep the babies memories alive by acknowledging their births and their existence, albeit fleeting, in your family. Your brother and his wife are parents, they just don't have any living children. I hated when others defined me as not a parent/mother. I gave birth and then buried two children. That's parenting too.

And take care of yourself. Go to a support group if you feel it might help. Though not as devastating, you suffered a loss too. mother of Ava, Rachel, and Jason

There are several great organizations available to parents who have suffered neonatal losses. You may want to check out the March of Dimes website,, which has a pretty good list of various available support organizations. Many of the websites provide advice for concerned family members who want to help parents going through this. CLIMB is a wonderful organization that focuses on neonatal deaths in multiple pregnancies, and SAND (Support after Neonatal Death) is run locally, out of Alta Bates Hospital. The amazing Betty Simmons runs it, and she might have some additional resources to suggest for your brother and his wife in LA as they navigate this tragedy. Good luck to you and your family. This is a sadness like no other. been there

I know how it feels to have a sibling loose a preemie baby when you have heatlhy children. My sister lost a preemie son after two days of life last year and she has recently suffered a miscarriage also. I have a 2 yr old son and are 5 mths pregnant with our second.

After the baby died I called my sister everyday until she told me that she'd call me in a couple of days, I then knew that she was doing better. I'd listen to her mostly and let her talk about how she was feeling. Some days were unbearable for her and she'd just cry on the phone and I'd cry with her. We'd talk about the pregnancy, the birth, the hopes she had and also of course try and figure out what went wrong. I never visited her as she asked me not to, I live in Oakland and she lives in England. She also said that talking on the phone and having someone just listen to her was the greatest help she ever had through the rough times. Her husband however, didn't deal with his grief aswell and bottled it up for a few months, he felt that he should be strong for my sister as she was the one who carried the child and gave birth, he said he never felt like a father. Don't let your brother feel that way, make sure he knows that the child was just as much his, as his wifes. He was and always will be a dad. It tore my heart out not to be with my sister but in the end I realised she just needed to talk and that she and her husband needed to work through their grief together alone. I visited her at last Christmas after the baby had died in August, she was doing well and had a fantastic attitude towards why this has happened to her and had realised no one was to blame. Of course they tried again this year only to have a miscarriage in August (unfortunately on the same day her son died last year). She is going to try again and will keep trying again until she has a child.

She visits the baby cementry when she wants to be near her son and had a plaque made in his name. She kept his pictures, the good luck cards and preemie clothing she was given and made a memory box for him, she looks at it when she feels brave enough but still cries. The only thing she doesn't understand is why she misses something she never really had and I can't explain that, I just tell her to have hope and never forget the beautiful baby she had.

I also contacted a group called Compassionate Friends, they are world wide and they sent a lot of information on grief and the different ways it can represent itself. Their website is and the Alameda County chapter tel # is 510 835 3579.

Please let me know if you have anymore questions or just need a person to talk to yourself, I hope I have helped. Just be there for your brother, let him know you love him and his wife. Time does heal, I thought I'd never get over the babies loss but here we are one year later and things are alot easier for my sister and myself. Take Care. helen

I had a miscarriage and was, of course, completely devastated. At the time, nothing really helped. My mother in law sent me a nice plant arrangement (I'm sure because she didn't really know how else to help). I transplanted one of the plants and now I enjoy seeing it grow and remembering the baby I lost/never really knew. It reminds me how old the baby would have been, etc. I am a terrible gardener...everything dies...but this plant has thrived. It makes me feel better. Lucy

I'm am SO sorry to hear about your brother & sister-in-law's losses. I can't even begin to imagine. I've had a couple of miscarriages and the pain was immense. The idea of carrying babies for such a long time and then losing them seems beyond unbearable to me. I have a copy of an article that helped some - may be better for you than them - you decide. It does recommend some excellent books. Email me your address and I'll send it to you directly. Alison

A wonderful organization for parents who have lost children is Compassionate Friends. They offer support groups for parents who have lost children of any age including those lost through miscarriage or stillbirth. ymb

I am so sorry for your family's loss. I'm sure your brother and his wife appreciate your support very much.

My twins were stillborn at 27 weeks a year ago, and I have to say that just having people reach out to us helped a lot. Call them often. Let them talk about it or not talk about it, depending on what kind of day they're having. Don't be afraid if they get emotional. Don't try to cheer them up. They don't need to cheer up, they need to grieve. Go down there if you can and if it's OK with them. I was amazed at how much small gestures of caring meant to me--things like the flowers my office sent to the hospital a few hours after I was admitted, and sympathy cards. From family, it helped (and still helps) to know that they miss our sons too. I was very thankful they came out here for the memorial service. The loss was very real and treating it like any death in the family was crucial to us in those early days.

Acquaintences who'd had losses of their own brought us some excellent books that we found very helpful. ''Empty Cradle, Broken Heart'' by psychologist Deborah L. Davis was a good walk through the emotions that surround pregnancy and neonatal loss. ''Tears of Sorrow, Seeds of Hope'' by Rabbi Nina Beth Cardin is a wonderful book of prayers for those struggling with infertility and grieving pregnancy loss (from a Jewish perspective). Although I wouldn't suggest these to them yet, if they decide to try again, there are also some good books for people who are pregnant again after a loss (''Trying Again'' and ''Pregnancy After a Loss'').

There are several Web sites dedicated to pregancy and neonatal loss--Alta Bates gave me a list before I left the hospital--but I never used any of them enough to suggest one over the others. The only one I really looked at was I found Web sites and the local support group to be a mixed bag. On the one hand, it was comforting to talk to people who were feeling similar emotions, on the other hand, you hear a whole lot of other ways that babies die.

Take care, and please feel free to send me a note if I can help in any way. They have a long, hard road ahead of them. Just do what you can to be there for them. The small stuff really does help. Pam

That is a tough one...I am going through a similar situation with a friend of mine -- gave birth to a boy at 30 weeks who lived a pregnant a few months later and miscarried...Her son that died would be three-weeks younger than my younger daughter who is 6 1/2 months.

All I can say is 'be there for them.' My friend wants to show me pictures and talk about him. I look and I listen. I hug her and I cry. I use Charlie's name when I talk about him. She takes the lead.

I guess that may not be very helpful. But, there aren't any easy answers, -hear you on this one...

Your original post and the subsequent advice from so many other people who have lost babies touched me profoundly and I have finally decided to post my own experience. Speaking from 12 years into the loss of my daughter who was stillborn, I have this to say:

You never, ever get over the loss of a child. But you learn to live with it. You grow, you get stronger, and you deal. It becomes part of who you are. It is a permanent scar. The sooner you stop trying to ''get over it'' the sooner you will be able to continue with your life. A changed life. I was hurt and impeded in this process by people thinking it was time for me to get over it. It took years for me to realize I never would, even more years to know that it was OK. I just needed to ''get on with it'' which is different because when you get on with it, you take ''it'' with you. When you are trying to get over it, you leave it behind, which is impossible so you can get stuck there.

About three months after my baby died, the sympathy and understanding mostly dried up. People moved on and I was left behind. There were a few impatient comments like ''don't you think it is time you got over it?'' So I hid my pain, I hid my memories. I became a model of fortitude. But every day, every single day my daughter was not still not there. Every time a stream of cousins ran by at family events, I could see the gap, the missing girl. In my mind she grew, now she's 12. When I take a walk with my little sister (who is 11) and she's running ahead, my daughter is not there beside her and so it goes.

One September morning when I took my son to his first day of 3rd grade, I was inexplicably sad. All day long. It finally dawned on me that that would have been my daughter's first day of Kindergarden when a friend mentioned her daughter's first day. The subconscious brain remembers even when the conscious one does not. This is normal.

The turning point for me came when a friend (with a daughter the same age) sent me flowers on my daugther's 7th birthday. She had not known me when it happened, but I had told her about it. Up until then, my daughter's birth day was the loneliest day of every year. Slowly over the next years I started to take out her box and create an altar out of the things in it on her birth day. I have a butterfly for every year (made out of feathers, and other things)and about two years ago I added a butterfly stamp (because I couldn't find any other kind of butterfly).

Surprisingly my other children (and now grandchidren) took to this tradition and participate fully. They move things around, add their own things and talk about it. Last year my oldest daughter brought her boys shortly after the altar was up (I put it in a very accessible place). They looked at all the cool little things (baby mementos and some things that would appeal to an 11 year old). Then they stamped their hands with the butterfly. Now everyone that visits the altar stamps their hand.

This year my nephew was doing kirigami (paper cutting) that day and taped one behind the altar. The paper and scissors became part of the altar and soon everyone, family and friends, was creating colorful cutouts to decorate the wall behind the altar, they all had butterfly stamps on their hands and cheeks. For this day, my daughter was there, for all of us. It has become a family holiday. I could not have designed this tradition. It grew because I learned to be comfortable with my pain (it hurts, but you don't have to be afraid of it), so my people feel comfortable around me and I am able to share the moment with them, even if they don't feel same way I do.

One word of advice to those who care about someone who has lost a child. Don't stop inviting them to your baby showers, children's birthdays, or stop talking about your own babies. My community, with the best intentions in the world stopped inviting me to baby showers, conversations would stop when I came into the room, (they were even afraid to tell me when someone got pregnant). I finally had to crash a baby shower to get re-instated! They apologetically explained that they didn't want to remind me of my loss.

You cannot remind someone about something they can't forget. You can make them feel excluded, lonely and like a leper. Let them choose when they are ready to start attending baby showers and such, be understanding when they can't and let them know that when they are ready, they are welcome. a mother

Friend's newborn death

May 2003

A friend and collegue of mine just gave birth to a baby who will not survive. I am devastated -- and need some suggestions about concrete ways to help her. This is her first baby. I would like suggestions -- from people who have been through this tragedy (or close to somebody who has) about what helps, what hurts. Sad and Feeling Helpless Friend

In addition to the nice, comforting things you can do for your friend, don't forget that you also need to grieve. Find a good friend or family member who is removed from the loss who you can turn to so you can talk about _your_ feelings. When I was busy supporting my friends in their loss, I neglected to acknowledge my own feelings of the loss. I too had dreams of future growth and play with the child and needed to talk about my pain with someone other thatn the parents. Also, remember to support the Daddy or partner too. he or she, though not the childbearer, also has feelings of loss but is sometimes lost in the focus on Mom. He or she needs to talk talk talk too. a friend

I'm very sorry about your friend's baby. Helpful things to do send flowers, meals that can be frozen for later or donate money in memory of their baby to an organization of the parents choice; things to say I'm very sorry. Is there anything you need? Each year Alta Bates Summit Medical Center hosts a free community Memorial Service for Pregnancy and Infant Loss in October. Also, they have a booklet ''Pregnancy and Infant Loss Resource Guide'' which has local support groups, suggestions for coping, recommended books, internet site and local therapists. If you want to receive this or more info, call and leave your request at 510-204-1762. The info will be mailed to you. Hope this helps. Kathleen

My husband and I lost our firstborn unexpectedly (SIDS) soon after her birth so I have some idea of what your friend is going through. My experience is that everyone responds very differently to such loss but that having friends around makes a huge difference. We are Jewish and sat Shiva for our daughter (you stay in the house for seven days) and our community visited and brought us food. People continued to bring us food for at least the month after. This was a tremendous help, not only because I was post-partum but also because it gave us a sense that we were not alone. I wouldn't worry about ''saying the wrong thing'' -- don't try to cheer her up but listen to your friend and let her guide you. Don't assume that all interactions have to be very somber, I found myself laughing really hard with two girlfriends six days after my daughter's death and it was a relief. So, depending on your ability to help, I would suggest that you organize people bringing food to your friend and that you make sure to visit regularly (one friend came to cook dinner at our house once a week for two months). What doesn't really work is to say ''call me if you need anything'' -- it's often much too hard to pick up the phone. Instead, call when you go to the supermarket and ask if she needs anything. Finally, on a practical level, your friend's milk will come in and to cabbage leaves help stem the flow. Put them in the freezer and then put them in your bra to sleep with overnight (in the morning you smell like cabbage soup). Hope this helps. I feel for you and your friend. As I reread this, I realize that I'm only writing about the mother, but this is also devastating for the dad. I hope a dad will respond because I don't really know what to say from that perspective as my husband is so different from me. Anna

Your urge to do something ''concrete'' is a very good one. I'd like to suggest that you pick some small thing -- and do it with complete consistency, for the foreseeable future.

Maybe you can pick up the mail, shop at Monterey Market for fresh produce, cook dinner once/week (on the same day), do the laundry. If she's a good friend you can call every day or week to find out how things are going. You can't make things better, but you can take some lesser worry off the pile. A baby present would be bittersweet in this case -- but depending on the circumstances not out of order. A baby was born, and the world will never be quite the same.

The offer of help that always comes to my mind, was that of a neighbor who walked my dad's dog, every afternoon for 13 weeks he was visiting the hospital when my mom died. After the initial offer was made and accepted they didn't even talk, most days. The neighbor came and got the dog, made sure he got a good run, then went home. Actions speak louder than words -- when words can't express.... Heather

Three friends of mine who lost babies told me that they wanted to be acknowledged as mothers. They wanted to be asked the same questions as moms whose babies survived -- the baby's name, weight, length. I don't know if this is true for your friend, but since three women told me this, I'm passing it along. I am sorry for this terrible loss. anon

I am sorry to hear of your friend's baby. I also lost my first child in infancy also. I'll tell you what helped me to get through it. 1. Don't ignore the loss, acknowledge that the baby was a person 2. Follow your friend's lead (if she wants to talk, then let her and if not, then don't push her) 3. Instead of asking ''what can I do for you'' - just do things (cook, clean, pack up the nursery, take her to a baseball game, concert, etc.). 4. Avoid cliches (you can always have another baby, baby's in a better place, at least you didn't have baby for long, etc.) - those comments are quite irritating 5. Help her find support groups, therapy, online groups dealing with loss. The #1 thing that helped me deal with my loss is talking to others who had survived the same type of loss; only they could truly empathize. Grieving the loss in a healthy way is critical. I would also suggest support for the partner/spouse; a loss of that magnitude is shattering 6. If your friend is religious/spiritual; perhaps support from a pastor/spiritual guide would also be helpful. 7. Be there (not just when it hurts critically) but whenever she needs you in the future. I'd be pleased to be available for future questions or to chat with your friend. p.s. I found baby grief books depressing but that might also be a resource. calgal

When I had a late-term miscarriage, what I needed most was people who would listen to me and be loving without taking on my grief and fear. Practical support is nice, too a basket of cheese and bread, fruit and wine, and chocolate for an instant dinner; an offer to housesit if your friend wants to get away for a quiet weekend. Also, ask her what she needs. Assume nothing, but be ready to give whatever you can. And bless you for thinking about your friend and asking for suggestions; too many people feel so awkward in the face of bereavement that they don't say or do anything at all. Melanie

This can be a heartbreaking time for you and her. I had the unfortunate experience of having two close friends lose their babies within a week of each other. I was a bit shell-shocked. After all the hopes and excitement, it's hard to have a loss, and it's hard to grieve for a child you didn't have the chance to see grow. You grieve for the lost days of wonder and joy. For me, and my friends, talking was needed - don't be afraid to ask about the child. The child will have a name and a special, never lost part of your hearts. Time will, eventually help, but for now, talk, grieve, cry. go for walks together. Don't ignore the loss, acknowledge it. Don't say ''I know what you are feeling'' say ''I'd like to help, let's go for a walk, shop for a christening dress for the babe, make dinner, let me contact others to let them know, etc.'' You need to suggest, or just simply do, things, making even simple decisions can be overwhelming, do laundry, mop the floor, find boxes for packing, etc. MOve out/pack away some (but not all) of the baby things that were readied. Part of the healing process will be for your friend to put away the baby things when she is ready. ANd part of the grieving will be to treasure some of those things as specifically that babe's. You might get a little baby book and collect togehter for her a lock of hair, foot prints, pictures, as well as babyshower memories and condolences cards as a small keepsake she can later take out when she needs to. And remember, presuming she has more children, that this babe is still her first child, regardless of length of life. A friend who's been there

My best friends' baby died in childbirth when I was 5 months pregnant. We had a lot of plans together and a year a half later our friendship is not mended. I don't really expect that it will till they have another baby (which they have desperately trying to do but to no avail). They didn't want to see us so I can only talk from the point of view of someone who really couldn't be there for them but what I do know is that they appreciated this; I do talk about him freely with them. I don't ever pretend he didn't exist because he is always in the back of their mind. Always. I sent them gifts like computer games when my friend was recovering from a c-section and infection. Things that for moments could take her mind off the death. We sent candy from godiva, notes like thinking of you. I don't ever assume ''they'll get over it'', they won't, I just ask if this day was hard or easier than the day before. On the anniversary of his birth/death we sent a bottle of vodka and kalua with a note that just read ''Irish Therapy''. (I'm irish, she's a shrink). That's all it said, it was a horrible day for them and they appreciated that someone knew that it was a horrible day for them. It was important that we remembered and more importantly, we ''got it''. Anyway, of course I don't know your friend that may not work but just being there in the way they wanted us to be. We talk about him but we also know when to stop talking about him. The best thing was we let them decide what they need from us and we respect that. erin

It is very sensitive and thoughtful of you to ask how you can help your friend. I know from personal experience that he/ she is going through a horrible ordeal. Here are some suggestions

- Say you're sorry. Keep it simple. DON'T say that you know how they feel, that this was ''meant to be'' or that they ''can always have more children.''
- Feel them out to see if they want visitors. They may want to just be with family or by themselves through this difficult time.
- Drop off a complete dinner or a bag of groceries. Chances are, your friends will be in no mood to go out and deal with this stuff themselves. It will be GREATLY appreciated.
- If they are spending a lot of time at the hospital with their baby then offer to take in their mail, pick up their newspapers, water their gardens, walk/feed their pets, etc.
- If they are planning a memorial service for their baby, volunteer to help with logistics, to help xerox programs, pick up the catering, etc.
- Be prepared to have your offers to help rejected. Don't be offended -- they may just want to be alone for a while.

The idea here is to provide a lot of background support, which they will need to get through this very emotionally raw time. In terms of emotional support, that is more difficult and will really depend on how close you are. Based on my own experience, it may be more helpful for your friends to find other parents who have gone through a similar experience (via a support group, such as Alta Bates' Support After Neonatal Death) or to seek professional help, such as a grief counselor. Hope this helps, Rockridge Mom

I work with families of children born with severe problems who sometimes survive only days. What parents seem to find most helpful when facing the loss of their child is if those around them treat this very short time as a full life, measured in days instead of decades, but a full-fledged life nonetheless. They will often speak with gratitude afterward about measures that allowed them just a few days with their baby, just time to hold him and tell him he is loved. We talk about how the time was short, but for the baby's whole life all they really knew was love. They want people to ooh and aah over how ''sweet'' the baby is like any parent, they want to as much as possible celebrate that life and save the grief for when it comes to an end. Don't be afraid to show some joy in that precious little life. anon

Your friend is lucky to have a friend who wants to say and do the ''right'' things surrounding her infant's death. I have two living daughters, number one and three, who are now 9 and 2 years old. My second and fourth daughters died full term from uterine ruptures. Our second daughter was still born while our fourth daughter, born December 2002 was resucitated and on life support for two days until I could be with my husband to take her off life support. Ironically, both girls were born in December, six years apart.

First, nothing in life prepares you for the death of your child. There is no way anyone can know how devastating the experience is. I appreciated having people acknowlege my grief and admit they didn't know what to say, rather than not say anything for lack of words. We received some very thoughtful, touching, and profound sympathy cards from unexpected sources. It is okay to not know what to say. Honestly, sometimes I didn't know what to say. Our community gathered around us in many ways. Some would hug us and talk. Some brought over dinners. Some helped out with our children. My best girlfriends really rallied around me. I knew I could call them whenever I needed to talk. Not surprisingly, I needed to talk much more than my husband did. My girlfriends saved me hundreds in therapy! Also, be careful about the words you choose while trying to offer comfort. While intellectually you know your child would have a terrible life if kept on life support, turning off the machine was the hardest thing I have ever had to do in my life. Our daughter looked like she was sleeping ... I kept expecting her to wake up.

Also, let your friend know there are support groups specifically for neonatal death. They usually meet twice a month and are free. They are usually called SAND or HAND, Support/Hand After Neonatal Death. These groups can be very helpful. There is something comforting about sitting among a group of peers who have had a similar experience. These people can cry and laugh with you. I would encourage her to go to several sessions.

There is a great book a friend gave me about 4 weeks after our second daughter died. A Silent Sorrow Pregnancy Loss by Kohn and Moffitt. It deals with all types of pregnancy loss from first trimester to neonatal death. It has chapters about family, friends, subsequent pregnancies, grandparents, memorial services, you name it. This book really helped me and gave me the courage to get pregnant again. Although I confess, I spent my third pregnancy convinced my daughter was going to die ... but that is another story!

In another book about loss, the author gave a great example about grief that I found to be true. Grieving is like standing at the edge of the ocean. In the beginning, the waves are big and continuous. They knock you over. As time goes by, the waves get smaller and are not as frequent. Eventually, the water just laps around your ankles and you can remain standing. I promise your friend, it does get better with time. Your child's birthday and the anniversary of it's death are difficult for several years. Eventually, you compartmentalize your grief and keep it tucked away for longer periods of time. In the beginning you are just raw emotion. Expect it. Also, just when you think things are getting better, something happens and transports you to the day your child died. Grieving is not a linear process.

I hope some of this helps you and your friend. Your friendship is the greatest gift you can offer her during this incredible difficult time. Sabrina