A child’s illness or injury can deeply upset her brothers and sisters. If the injury is serious or the illness prolonged, parents may have little time or energy to focus on the siblings. Siblings may be flooded with anger and concern, jealousy and love. If you recognize that these emotions are normal, you will be better able to help your children talk about and cope with their strong feelings. Some emotions the siblings may experience include:

• Concern. Children really worry about a sick brother or sister. It is hard for them to watch someone they love be hurt by an injury, surgery, or treatment for an illness. It is hard to feel so healthy and full of energy when your brother or sister has to stay in the hospital.

• Fear. Even if a brother or sister is injured or suffering from a non-communicable illness, young siblings may fear that they, their parents, or friends can “catch it.” An illness or injury can also change a child’s view that the world is a safe place. Depending on their age, siblings may worry that their brother or sister will get sicker. Fear of other things may emerge: fear of being hit by a car, fear of dogs, fear of strangers. Many fears can be quieted by accurate and age-appropriate explanations from parents or medical staff.

• Guilt. Young children are egocentric; they believe the world revolves around them. It is logical for them to feel that they caused the illness or injury. You should try to dispel this notion right away. Children should be told that sickness and injury just happen, and no one in the family causes them.

• Jealousy. Despite feeling concerned for an ill brother or sister, siblings may also feel jealous. In the case of a serious injury or illness, presents and cards flood in for the sick child, mom and dad stay at the hospital with the sick child, and most conversations revolve around the sick child. When the siblings go out to play, the neighbors ask about the sick child. At school, teachers are concerned about the sick child. Is it any wonder that they feel jealous?

• Abandonment. If all of your attention is focused on your ill child, your other children may feel isolated and resentful. Even when you make a conscious effort not to be preoccupied with their ill brother or sister, siblings often believe that they are not getting their fair share of attention, and may feel rejected.

• Anger. If siblings’ lives are in turmoil, they may feel a need to blame someone. It’s natural for them to think that if their brother didn’t get sick, life would be back to normal. When the illness or injury is severe, questions such as, “Why did this happen to us?” or, “Why can’t things be the way they used to be?” are common. Children’s anger may be directed at their sick brother, their parents, relatives, friends, or the doctor. The anger may have many triggers, such as being left with baby-sitters, unequal application of family rules, or additional responsibilities at home. Because each member of the family may have frayed nerves, angry outbursts can occur.

• Worry. Children have vivid imaginations, especially when they are fueled by disrupted households and whispered conversations between parents. Frequent age-appropriate explanations can help children better understand what happens at the hospital, but nothing is as powerful as a visit. The effectiveness of a visit will depend on your child’s age and temperament, but many parents say bringing the siblings along helps everyone. The sibling gains an accurate understanding of hospital procedures, the sick child is comforted by the presence of the sibling, and parents get to spend time with all their children.

• Concern about parents. Parents focused on helping their sick child get through an illness or injury often are not aware of their healthy children’s strong feelings. They sometimes assume that children understand that they are loved, and would get the same attention if they were sick or injured. But siblings often do not share their feelings of anger, jealousy, or worry because they do not want to place additional burdens on their parents. It is all too common to hear siblings say, “I have to be the strong one. I don’t want to cause my parents any more pain.” But burdens are lighter if shared, and parents should try to encourage all their children to talk about how they are feeling.