Sibling & Peer Support

Siblings and peers are a very important figure in the life of a patient. Different children will react in a number of different ways when a sibling or peer is hospitalized. The healthy child's reaction can vary depending on age, developmental level, seriousness of the hospitalized child's illness or condition. It is important to remember not every child will have the same reaction to the hospital and feelings can change on a daily basis. 

Common Reactions

Here are some common feelings siblings and peers may experience:

  • Confusion, Anger, Fear, Abandonment, Resentment, and Embarrassment
  • Guilt and/or Blame (i.e. the sibling or peer may feel responsible for the hospitalized child's condition)
  • Rejection (i.e. the sibling or peer may view the parent's attention with the hospitalized child as a negative act)

It might be hard for the healthy child to express these feelings verbally, but the child may be able to act them out through their behavior. Here are some typical behaviors siblings and peers may act out:

  • Becoming more clingy or dependent on parent
  • Change in eating behaviors
  • Withdrawing from friends and family
  • Misbehaving or sudden emotional outbursts
  • Returning to habits from a younger age (i.e. bedwetting, thumb sucking, etc.)
  • Poor school performance
  • Becoming obsessed with patient; may even complain of similar symptoms

How to Cope

Here are some things that the siblings and peers can do with or for the hospitalized child:

  • Tape record a bedtime story to share
  • Write letters or tape messages to each other
  • Make cards and pictures for each other
  • Have a photo exchange
  • Allow the healthy children to visit the patient in the hospital
    • Sibling and peer visits can be arranged with the nursing and Child Life staff.
    • Visiting children can receive education about the patient's medical condition and be prepared for what they will see at the hospital.
    • Child Life staff can accompany visiting children to the patient's room and provide support during and after the visitation.

Tips for Caregivers

Here are some hints to help siblings and peers cope better with the hospital experience of your child:

  • Answer their questions honestly
  • Advocate for their presence whenever possible
  • Provide appropriate explanations to siblings and peers
  • Include siblings in the care and decision making process as appropriate
  • Allow for discussions and expression of feelings
  • Contact your Child Life Specialist for help in the hospital
  • Contact your school's Guidance Counselor for help outside the hospital


Thompson, R.H. (2009). The handbook of child life: A guide for pediatric psychosocial
care. Illinois: Charles C. Thomas, Publisher LTD.

The Nebraska Medical Center. Kids worry too. [Brochure]. Omaha, NE: Singer, Lynette.

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