Supporting Siblings of Children with Burn Injuries
Written by Ayla Mapes, PhD on March 24, 2026
When a child experiences a burn injury, it impacts the entire family. Routines shift, responsibilities change, and emotions run high. Long hospital stays, time away from home, and temporary separations can be especially challenging. While much of the family’s attention is naturally focused on the child who is injured, siblings are also navigating fear, confusion, and loss of normalcy—and they need care and support, too.
Caregivers can promote emotional healing for all children in the family by helping siblings remain connected during a difficult time. By helping them feel informed, included, and emotionally supported families can promote healing for everyone involved.
Help Siblings Feel Included and Informed
Caregivers might feel the need to protect siblings by withholding information about the injured child, but not knowing what is happening can increase their fear and anxiety. Siblings may imagine scenarios that are far scarier than reality or blame themselves for what happened.
Including siblings in a child’s recovery, at an age-appropriate level, can help reduce uncertainty and build trust. Give them honest, simple information about the injury and recovery. Avoid overwhelming details or medical language, and invite questions as they arise. It’s okay to say, “I don’t know yet,” or “The doctors are still figuring that out.” Regular updates, even small ones, can help siblings feel reassured and connected.
Involving siblings in care in small, meaningful ways can also be helpful. This might include:
Letting them choose or bring a comfort item for their sibling
Helping decorate a hospital room with drawings or photos
Sitting nearby and holding a hand, if appropriate
Being involved helps siblings become more familiar with bandages, scars, or medical equipment, reducing fear of the unknown. When visitors bring gifts or attention for the injured child, try to include siblings as well, so they feel recognized and valued.
Preparing Siblings for Hospital Visits
Visiting a sibling in the hospital can be scary at first, but having a plan can help reduce their fear. If an in-person visit feels too intimidating, consider starting with a phone call, video chat, or recorded message.
When preparing siblings for hospital visits, involve members of the care team such as a child life specialist or psychologist. It might be helpful to plan the visit when it feels less overwhelming, such as when their sibling has fewer bandages or less swelling.
Talk with them ahead of time about what they might see, such as bandages, bruises, swelling, or monitors. It’s also good to plan coping strategies in advance. Encourage siblings to bring a comfort item, favorite activity, or something familiar that helps them feel safe. Let them know they can take breaks or leave the room if things feel like too much.
Use Routine to Create Safety, Stability, and Predictable Connection
Changes in routine and temporary separation can be upsetting for both you and your child. Young siblings may feel confused, worried, or even responsible for what’s happening. Some children may feel jealous of the attention given to the injured child and express those feelings through behavior. Maintaining regular routines can provide reassurance and predictability.This includes consistent bedtimes, morning rituals, rules, and expectations—along with regular moments of connection with caregivers.
It can be challenging to maintain routines when family members are in the hospital. One strategy is to create condensed versions of routines that include the most important parts. Pick two to three activities that are always part of the routine regardless of time or location. For example:
Bedtime could always include a relaxing activity, brushing teeth, putting on pajamas, even if routine is at a different house with other caregivers.
Another helpful routine is predictable one-on-one time with your child. Give the activity a name (like “special five minutes”) and set a timer so your child knows when it starts and ends (even if it happens at a different time or only on certain days). Spending quality time together for just five minutes can make a big difference.
Supporting Emotional Reactions and Behavior Changes
Siblings of a burn survivor may experience heavy emotions such as anxiety, sadness, confusion, or guilt. These feelings are normal and come with big changes and uncertainty and may change day by day. Young children may not have the words to express their thoughts and feelings. They might show stress through behavioral changes like tantrums, withdrawal, or regression (e.g., less independence, returning to earlier behaviors).
Caregivers can support emotional expression and coping in several ways:
Recognize and validate feelings. Give your child time to share how they feel. Reflect what you hear: “It sounds like you’re worried about your sister.” If needed, use feeling charts or help label their feelings for them” “You seemed worried today. Tell me about it.”
Model healthy emotional expression. Caregivers often want to protect children by hiding their own emotional reactions. While it’s important to be thoughtful of how you show your emotions, it can be helpful to let them know you get scared or worried too—it normalizes the experience of emotions.
Encourage, model, and praise coping strategies. Caregivers can help children create “feel better plans,” or lists of activities that help children feel better when they’re upset. Model using these skills and praise your child for using them: “I really liked how you took deep breaths when you were worried.” Helpful coping ideas may include:
Talking to supportive adults or professionals
Go for walks or spending time outside
Listening to music
Engaging in fun activities
Mindfulness practices like deep breathing or meditation
Encourage Connection Between Siblings
While it can be challenging, it is valuable to maintain connection between siblings during treatment. Even if they cannot visit in person, siblings can stay involved through activities such as:
Making cards, drawings, or small gifts
Sharing video calls, voice messages, or recorded stories
It can be beneficial for siblings to engage in activities they would normally enjoy together, such as sharing favorite movies, games, or books. Activities may need to be adapted, but even small opportunities for usual play can help children feel connected, supported, and adjust better.
Seek Extra Support When Needed
Professional support can benefit the entire family during hospitalization and after discharge. Ask your care team about available mental health resources, including counseling or therapy. Evidence-based approaches, such as cognitive behavioral therapy, can help children develop healthy coping skills.
Additional support may also come from child-focused hospital staff or school counselors, who can help siblings process their experiences and manage changes at school or home.
Supporting Healing for the Whole Family
A burn injury affects every member of the family in different ways. With understanding, support, and time, siblings can adjust, cope, and find their own ways to manage the changes. By acknowledging their experiences and meeting their emotional needs, caregivers help create a foundation for healing—not just for the injured child, but for the entire family.
Dr. Ayla Mapes is a pediatric psychologist and Director of Inpatient Programming at Akron Children’s Hospital, as well as an Associate Professor at Northeast Ohio Medical University (NEOMED). Her clinical care and research centers on improving access to evidence-based behavioral health services for underserved and trauma-exposed children and families, with a strong focus on integrated care and trauma-informed approaches. For the past three years, Dr. Mapes has worked closely with pediatric burn survivors and their families in the Akron Children’s Burn Unit, providing inpatient and outpatient psychological support and contributing to multidisciplinary team care.
References
Bayuo, J., & Wong, F. K. Y. (2021). Issues and concerns of family members of burn patients: A scoping review. Burns: Journal of the International Society for Burn Injuries, 47(3), 503–524. https://doi.org/10.1016/j.burns.2020.04.023
Lehna C. (2010). Sibling experiences after a major childhood burn injury. Pediatric Nursing, 36(5), 245–252.
Mancuso, M. G., Bishop, S., Blakeney, P., Robert, R., & Gaa, J. (2003). Impact on the family: psychosocial adjustment of siblings of children who survive serious burns. The Journal of Burn Care & Rehabilitation, 24(2), 110–118. https://doi.org/10.1097/01.BCR.0000054169.02965.C4
Phillips, C., Fussell, A., & Rumsey, N. (2007). Considerations for psychosocial support following burn injury--a family perspective. Burns: Journal of the International Society for Burn Injuries, 33(8), 986–994. https://doi.org/10.1016/j.burns.2007.01.010
Selman, S. B., & Dilworth‐Bart, J. E. (2024). Routines and child development: A systematic review. Journal of Family Theory & Review, 16(2), 272–328. https://doi.org/10.1111/jftr.12549
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