Esther Wender, M.D., and colleagues from the American Academy of Pediatrics' Committee on Psychosocial Aspects of Child and Family Health, present guidelines to help pediatricians provide support to the parents and any siblings still in his or her practice after the death of a child.The researchers acknowledge that pediatricians may be reluctant to become involved given the pain of confronting grieving family members, but they are well placed to assist families through their grief with the aim of preventing future problems. Pediatricians should be aware that the grief after the loss of a child is intense, and may last longer than many expect -- usually years. Failure to acknowledge the death of an infant, child, or adolescent can contribute to the family's grief. Recognition of the special issues experienced by grieving siblings is important for follow-up with siblings who are still patients. Self-help support groups play an important role in helping parents, and pediatricians should become aware of such groups. In the case of suicide through use of alcohol or drugs, or homicide, the grief is particularly intense and is often accompanied by guilt and/or anger. Counseling should be considered in these cases. When the parents have preexisting psychiatric problems or had a troubled relationship with their child, grief is likely to be complicated and referral to a mental health professional may be appropriate.