What is a neonatal death?

A neonatal death is when a baby dies within the first 4 weeks (28 days) after they are born. It is also known as a newborn death. Most neonatal deaths happen in the first week after birth.

Neonatal death is different from stillbirth. A stillbirth is when a baby dies between 20 weeks of pregnancy and their birth.

Neonatal death is not common in Australia. There are about 700 neonatal deaths a year in Australia.

Dealing with a neonatal death can be very difficult for the whole family, but there is help and support available.

What are the causes of a neonatal death?

It’s not always known why a baby dies. However, the risk of neonatal death may be greater if a baby:

• is born prematurely
• has a low birthweight
• has a congenital disorder (medical condition)

The risk of neonatal death is also increased if a pregnancy has complications.

It can also be related to complications during labour.

Sudden unexpected death in infancy (SUDI) is a term used to describe the sudden and unexpected death of a baby that is less than 12 months old. Sudden infant death syndrome (SIDS) refers to deaths that are still unexplained after being fully investigated.

What should I expect after a neonatal death?

Losing a baby can be a very painful experience. Parents who experience a neonatal death often:

• feel shocked and devastated
• feel alone
• feel guilty or blame themselves
• find it hard to believe their baby has died
• feel anxious

Grief can also have physical effects, such as:

• loss of appetite
• headaches
• tummy aches
• insomnia

Everyone reacts differently. You may experience many different feelings at different times. Grief can also change over time. It can be made easier by having support.

If you have given birth, you will still produce milk after a neonatal death. This can be uncomfortable and sometimes painful, both physically and emotionally. For support, you can contact a:

• midwife
• child health nurse
• lactation consultant

See your doctor if:

• your breasts become painful, swollen and warm
• you develop a fever

You may choose to donate expressed milk to a milk bank. This is used to help other premature or sick babies.

Your body will also go through some of the normal changes that happen after birth. Learn more here about your body after a neonatal death.

What happens after a neonatal death?

Losing your baby can be overwhelming. You will have many things to think about. These things may make your grief feel worse, but there are ways to get through them.

Making funeral arrangements is something you will need to think about. By law, you must also register both the birth and the death of your baby with Births, Deaths and Marriages in your state or territory.

These things can be painful to organise while you are grieving. A hospital social worker or a maternal child health nurse can support you and guide you through the process. It can also help to have assistance from your family and friends.

Parents often find it helpful to know why their baby died. Talking to the health professionals who looked after you and your baby can help.

Some parents may request an autopsy. An autopsy is an examination to try to work out why a baby has died. It is also known as a post mortem examination.

An autopsy cannot be done without the parents’ consent and it’s up to you whether to agree to an autopsy after a neonatal death.

The only time when an autopsy may be carried out without consent is if the case is referred to a coroner. This might happen if the death occurred in suspicious circumstances or if it was something to do with the health care the baby received.

An autopsy is done by a trained pathologist (specialist doctor). If you agree to an autopsy, you can decide how detailed you would like it to be — whether it involves just examining the baby or removing organs to test why the death has happened.

Sometimes no cause of death can be found, even after an autopsy.

It’s a good idea to discuss the benefits and downsides of an autopsy with a:

• doctor
• midwife
• social worker

They can guide you through what needs to be done and will answer any questions you might have.

Creating memories

Taking the time to create memories of your baby to treasure later can help you heal.

You can:

• take lots of photos with your baby
• hold and cuddle them
• take a lock of their hair
• make handprints or footprints
• keep the cards or dry the flowers you receive
• write a journal

You can also make a memorial for your baby. You could:

• find a special place in the garden to plant a tree for them
• choose a song to remember them by

Do whatever feels right for you.

Taking your time

Many parents wish to spend some time with their baby. You can ask to take the baby home with you, or visit them in the funeral home. This time is precious, so take as long as you like.

When you are ready, you can say goodbye. The hospital or a funeral director can take your baby to a funeral home.

Emotional support

If you lose a baby, it may feel like no-one else can understand your grief. But involving others in the grieving process can help provide emotional support.

Family and friends

The death of a baby can be devastating for the whole family. Many bereaved parents find it helpful to invite family members to see the baby. If you have other children, it’s important to involve them too. This can help them to understand your grief and support you.

It can take a long time to deal with a neonatal death. It’s okay to grieve in private. You don’t have to see people straight away. You can reach out to accept your loved ones’ support when you are ready.

Support groups

Meeting with other parents who have experienced neonatal death can help. You can find support:

• in person at local support groups
• online

See the Resources and support section below for more information.

Your partner

Both parents can be overwhelmed with grief when dealing with a neonatal death. Your relationship may be strained as you both deal with feelings in different ways.

To get through such a hard time, it’s important to:

• communicate openly and honestly
• support each other

Financial support

Some parents may be eligible for government support after a neonatal death. Government payments include Family Tax Benefit bereavement payment for up to 14 weeks.

You can visit Services Australia for more information.

Resources and support

Your doctor, midwife, maternal child health nurse or social worker will be able to guide you through what happens after your baby has died. They will also be able to advise you about who can help if your grief becomes overwhelming.

You can find more information, resources and support through:

• Red Nose Grief and Loss
• Grief Australia
• Pregnancy Loss Australia

Lifeline supports anyone having a personal crisis — call 13 11 14 or chat online.

Griefline provides telephone support — call 1300 845 745, Mon to Fri, 8am to 8pm (AEST).