Share on Pinterest
d3sign/Getty Images
  • Grief can affect kids differently and how they respond may depend on their age, temperament, and relationship to loved ones.
  • In addition to sadness, Black children may experience another layer of grief if they are aware of healthcare inequities.
  • Listening to children and validating their feelings are important ways parents can help them heal.

New research sheds light on the tragic toll the COVID-19 pandemic has had on American children.

The report, published in JAMA Pediatrics, finds an estimated 40,000 children in the United States have lost at least one parent to the virus.

“Children who lose a parent are at elevated risk of traumatic grief, depression, poor educational outcomes, and unintentional death or suicide, and these consequences can persist into adulthood,” the authors wrote in the report.

Using a statistical model, the researchers determined that as of February 2021, between 37,000 and 43,000 children age 17 or younger had lost at least one parent to COVID-19. About three-quarters of those affected are teenagers.

“The burden will grow heavier as the death toll continues to mount,” the researchers warn.

Losing a parent is traumatic at any age and in any circumstance. But now, compounding that grief is a year plus of lockdown where routines have been disrupted and children have had to stay distanced from friends and other loved ones.

Healthline spoke with two childhood mental health experts about how this kind of trauma can affect children and what kinds of support they need now and moving forward.

Children experience grief in many different ways. “Grief is incredibly unique,” said Dr. Wanjiku Njoroge, medical director of the Young Child Clinic at Children’s Hospital of Philadelphia.

When it comes to how a child responds to the death of a parent, “much of it depends on the child’s age, the relationship the child had with that parent, their own temperament, and their relationship to their other support systems, such as other family members, friends, and loved ones,” she told Healthline.

Katherine Rosenblum, PhD, a child and adolescent psychologist at Michigan Medicine, notes that due to the nature of COVID-19, many children are struggling with both tragic and unexpected loss.

“It may have been really sudden or they may have lacked the opportunity to say goodbye and engage in cultural and religious observations and mourning rituals that help children and families through that process,” she said.

Younger children are typically affected in much different ways than older kids. For example, elementary-aged children often partake in what experts refer to as “magical thinking.”

“All kids will try to make sense of what happened, but the little ones tend to see things in very ego-centric ways, so they might worry that they did something wrong or that they caused it,” Rosenblum said.

This can especially play out in the time of COVID-19, where children may worry how their parents contracted the virus and if they played a role.

“It’s really important to listen to kids’ worries and reassure them that there’s nothing they did or didn’t do to cause this,” Rosenblum said.

Older children, particularly teens, can have a better handle on reality, though given the nature of COVID-19, it wouldn’t be uncommon for them to also worry if they were part of the reason their parent got sick, experts say. However, teens may also be dealing with more complex feelings.

“They may be struggling with feelings of guilt or worry if there were conflicts or challenges which are really normative in that developmental period, and worrying if their parent knew what they meant to them,” Rosenblum said. “They may need a lot of reassurance that their parent knew how much they loved them.”

The death of a parent from COVID-19 may also prompt severe anxiety in kids of all ages about the health and safety of other loved ones.

Additionally, it’s important to note that there’s no time limit on grief and feelings of sadness, guilt, and anger may come on at different times.

“Children grieve differently and they also grieve for different lengths of time,” Njoroge said. “The loss of a parent in particular is a lifelong grief.”

Communities of color have been disproportionately affected by the COVID-19 pandemic. Statistics show Black, Latino, and Native American people are more likely to contract the coronavirus, be hospitalized, and die from the infection.

From the start of the pandemic, BIPOC individuals have made up a disproportionate number of essential workers and are also less likely to be insured and have greater barriers to accessing healthcare than non-Hispanic white individuals.

This is reflected in the current study, as Black children comprise just 14 percent of all children in the United States, but account for 20 percent of those who have lost a parent to COVID-19.

“This may add another layer to children’s grief depending on how aware they are of that reality,” Njoroge said. “It’s an incredibly different experience from peers whose parents aren’t BIPOC.”

It’s normal, she says, for children to feel angry and to say things like “it isn’t fair” and “it shouldn’t have happened.”

Njoroge recommends giving kids space to have these emotions and validating their feelings.

“It’s hugely upsetting and it’s completely understandable to waver between grief and anger and admitting and talking about that,” she said.

“What that may do is encourage some kids to go into medicine or STEM fields and really help think about ways we can dismantle these systems that have led to these health inequities,” she continued.

In addition to listening and validating kids’ feelings, finding ways to remember the deceased can help them heal — something that can be particularly challenging during a pandemic.

“If you normally would have had a funeral service or a larger memorial in person, it can be very important to find ways to do these rituals as best you can,” Rosenblum said.

“That could be an in-person funeral with the people you live with or something online that brings together lots of people to share stories, honor memories, and remember the life.”

She suggests families may also want to create other rituals to honor the person.

“That might be something like planting a tree in that person’s honor or creating a box and collecting together things that were special about the person and talk about it and share it together with the people that you love,” she said.

Kids may also need a break from grieving and experts say it can be completely normal for them to distract themselves and engage in hobbies or other activities as part of the healing process.

Finally, Rosenblum emphasized how important it is for the remaining parent or caregiver to get support themselves.

“There isn’t one right way to do this,” she said, “but it’s OK to let other people help. A lot of times parents carry the burden of their own loss and the worry that they’re not able to meet all their children’s needs, but there’s no way to do this perfectly. Having self-compassion is really important.”

Children may experience grief in a number of ways. If you notice changes in any of the following behaviors, it may signal that they need professional help:

  • eating
  • sleeping
  • grooming habits (like showering or brushing their teeth)
  • avoiding virtual or in-person school and social engagements
  • show no interest in doing things they once enjoyed

“When children’s behaviors start impairing their daily life and ability to function, that’s when it goes beyond what the remaining parent and other families are able to handle and when they should seek help,” Njoroge said.

A pediatrician can be a great starting point who can help parents connect with a mental health provider to help kids navigate grief.

Other resources include: