What is neonatal death?

Neonatal death is when a baby dies within the first 28 days of life. Whether a baby dies soon after birth or after surviving a few weeks, it’s an incredibly difficult experience for the whole family.

There are many reasons why a baby might die in the first four weeks after birth. Sometimes it’s because the baby was born premature, had congenital abnormalities (birth defects) or became sick with an infection. Sometimes it’s because there were problems in pregnancy and complications in labour. And sometimes we just don’t know why.

Your baby’s death can bring up intense feelings of grief, emptiness, anger, anxiety and depression. How you and others feel and respond is unique, and there’s no one or right way to feel about it.

Spending time with your baby

Spending time with your baby creates memories and lets you acknowledge that your baby is or was a part of your family. Remembering and sharing these memories over time helps some people grieve. How you make memories of your baby is up to you and your family.

It’s OK to take as long as you need. Try not to feel pressured by other people’s expectations or experiences.

Spending time with your baby from birth
If you’ve been told your baby is unlikely to survive beyond four weeks, you can still spend time together from the moment your baby is born.

Nurses and midwives can help you hold and cuddle your baby as soon as possible.

You might name your baby and take photos together. And if you have other children, you might give them the chance to meet their sibling and have a photo taken together as a family.

Spending time with your baby when your baby has died
When your baby dies, you’ll have time with your baby. You might spend this time holding and cuddling your baby. You can name your baby, if you hadn’t done this already. Neonatal nurses and midwives can also help you to dress, bathe and take photos of your baby.

If you would like to spend a few days with your baby or take your baby home for a while, speak to your nurse or midwife, who can help to arrange this.

A neonatal death might affect other members of your family – children, grandparents and other relatives. You can decide whether you want to invite them to spend time with your baby.

Doctors, nurses, midwives, social workers, pastoral carers and your chosen funeral directors will help you with the things you need and want to do after your baby’s death.

Most hospitals will help you put some photos, footprints and a lock of your baby’s hair into a memory box. You can take this box home with you when you leave the hospital. If you prefer, the hospital can look after this box for you until you feel ready to collect it.

Saying goodbye to your baby

When you’re ready to say goodbye to your baby, your hospital and chosen funeral directors will coordinate your baby’s move to a funeral home. Your baby will be cared for with dignity and respect, just like any other person.

While your baby is at the funeral home, you can still visit your baby up until the burial or cremation. Speak to your funeral director, who can arrange this for you.

There are many people and organisations that can support you after a baby’s death. You might want to speak with a private bereavement counsellor. Or you could contact national support organisations like SANDS or Red Nose Grief and Loss. These organisations have support helplines that you can contact 24 hours a day, 7 days a week.

For women: your body after neonatal death

Bleeding
After birth, you might have some vaginal bleeding for 5-10 days. For some women, this can last up to six weeks. This is normal. It’s important to see a GP or obstetrician if you have:

  • heavy bleeding that doesn’t stop
  • severe abdominal cramps
  • signs of a fever.

Milk suppression
Milk suppression – or stopping breastfeeding and expressing – can be physically and emotionally difficult after a neonatal death. It can be a few weeks before your breasts stop producing milk.

To prevent engorged breasts, it helps to express breastmilk sometimes. Express just enough for comfort – expressing too much can stimulate an increase in supply. Neonatal nurses, midwives and lactation consultants can give you advice and support during this time.

If there’s breast pain, swelling, warmth, fever and chills, it’s important to see a GP. This might be the beginnings of mastitis. Mastitis can happen when a milk duct becomes blocked. Massaging any lumps or expressing a small amount of milk can reduce the lumpiness.

It’s possible to donate frozen breastmilk to milk banks to feed premature babies. Speak to your nurse or midwife if this is something you’d like to do.

Understanding why your baby died

Your doctor might ask if you’d like to have an autopsy done on your baby to find out more about why your baby died. Knowing why a baby died helps some people grieve. The information might also help doctors give you advice about future pregnancies.

Sometimes an autopsy won’t be able to tell you why your baby died. Even if the autopsy can’t explain your baby’s death, knowing you tried to find out why your baby died can be reassuring.

If you don’t want to do an autopsy, there might be other examinations that can be done. Your doctor can explain if this is a possibility.

It can be hard to decide about having an autopsy done on your baby. Doctors, nurses, midwives, social workers and pastoral carers can support you in making the best choice for your family.

Causes of neonatal death

Often we don’t know the exact cause of neonatal death.

In Australia, causes of neonatal death include:

  • prematurity
  • low birth weight
  • congenital abnormalities (birth defects)
  • infection
  • complications during labour
  • problems during pregnancy.

Legal information about neonatal death

By law, all neonatal deaths in Australia must be registered with Births Deaths and Marriages in your state or territory. Visit your state or territory’s Births Deaths and Marriages website for more information.

In most states and territories in Australia, it’s also a legal requirement to arrange a burial or cremation for your baby.

In some cases, your baby’s death might require a coroner’s investigation to find out the cause of death. Hospital staff will guide you through this process if it needs to happen.