How to Talk to Young Children About Your Cancer Diagnosis

Being diagnosed and living with cancer can feel like an emotional roller coaster. If you are a parent of an infant or toddler, you might not think about the potential repercussions of your cancer diagnosis on them. It’s important to be aware of the effects of cancer on your entire family, even if some members are too young to verbalize their feelings. Telling your child about cancer should be done in an age-appropriate manner.

Infants to Toddlers

Infants and toddlers cannot understand illness or cancer, but they certainly sense when you aren’t feeling well. They cannot articulate feelings, but they perceive changes in day-to-day routines, and react to behavior and moods of everyone in the immediate family. This can manifest in the following:

  • Increased number of tantrums

  • Changes in eating and sleeping habits

  • Clingy, irritable, or fussy behavior

  • Difficulty separating from parents/caregivers

  • Unsettled demeanor, especially if breastfeeding stops suddenly

  • Wanting to breastfeed more often

  • Sucking thumb or fingers

Tips: Infants to Age 2

  • Babies pick up on your emotions, so try to vent with close relatives or friends to help alleviate obvious stress and nervousness.

  • Stick to your baby’s routine and ask any caregivers to also follow this schedule.

  • Pack a favorite blanket, toys, books, and clothes if your child needs to spend a night away from home.

  • Give a lot of hugs and cuddles to reassure them and extra breastfeeding to provide a feeling of security.

  • Say something to toddlers about being ill and reassure them you love them even if you have to stay in bed or go to the hospital.

Preschool to Kindergarten

At this age, children have some understanding of feeling sick, but cannot understand illness in relative terms, so they might equate cancer to having a cold. They may blame themselves for causing your cancer due to something they did, a behavior called “magical thinking.” Any of the following are common responses to a parent’s cancer.

  • Acting younger than their age (e.g., suddenly wetting the bed after being potty trained)

  • Being afraid of the dark, monsters, animals, strangers, or the unknown

  • Have nightmares, sleepwalking, or talking in their sleep

  • Stuttering or using baby talk

  • Being overly active

  • Showing disinterest in things

  • Separation anxiety, especially at bedtime and going to school

  • Behaving aggressively (e.g. hitting or biting)

  • Exhibiting short, intense bursts of emotion

  • Repeatedly asking the same questions (e.g. about cancer)

  • Playing or acting out themes related to illness (e.g. doctors or sickness)

Tips: Age 3 to 5

  • Explain what cancer is in simple terms using picture books, dolls, or stuffed animals.

  • Say you are getting medicine from your doctor to help you feel better and some days you might be tired. If they don’t understand, try repeating what you said or say it differently.

  • Provide reassurance your cancer wasn’t caused by anything they did or thought and it isn’t something you can catch like a cold.

  • Follow normal routines as much as possible including disciplining and limit-setting, daytime activities such as physical exercise, and bedtime rituals like reading stories.

  • Make them feel good by asking them to help you with little chores, draw pictures, sing songs, or act out little scenes. Compliment and thank them frequently.

Young School-Age

By the time children are age 6, they are able to understand cancer is more serious than a common cold and some might be aware people can die, including their parents. Things classmates say might lead to misunderstandings. You may want to tell your child’s teacher you have cancer so they are aware of its potential impact and can notify you of any problematic behaviors. Although they aren’t as prone to blaming themselves for your cancer as younger children, this can still happen. It’s important to be aware of this possibility and any of these signs.

  • Feeling sad and crying

  • Exhibiting irritability, anxiety, or guilt

  • Being nervous about separating from parents (e.g. going to school or camp)

  • Worrying about the health of the well parent

  • Getting easily embarrassed or ashamed

  • Being afraid of their performance, punishment, or new situations

  • Complaining of physical symptoms (e.g. headaches or stomachaches)

  • Regressing (e.g. wetting the bed)

  • Acting hostile even with the sick parent (e.g. yelling or picking fights)

  • Daydreaming or trouble concentrating and paying attention

  • Getting poor grades in school

  • Withdrawing from family and friends

  • Trying to be extra good and happy so parents don’t worry about them (especially common in girls)

Tips: Age 6-8

  • Be open and truthful about your cancer. Tell them you have cancer in simple terms (e.g. lumps growing in the body that shouldn’t be there). Say many people get cancer and the doctor is providing treatment to help you get well. Use books to explain your illness, treatment, and what might happen.

  • Provide reassurance your cancer wasn’t caused by anything they did or thought and it isn’t something you can catch like a cold.

  • Address the issue of dying even if they don’t ask about it.

  • If your child comes home from school with misinformation from friends about cancer, gently explain not everything they hear or read is true.

  • Help your child feel involved by giving them simple chores to do (e.g. making the bed, dusting or bringing you a blanket).

  • Allow and encourage them to spend time with friends and continue all extracurricular activities.

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