Siblings of Children with CHD

When you’re parenting a child with CHD, so much of your time, energy, and attention is—understandably—focused on their medical care and development.

Appointments. Hospitalizations. Therapies. School planning.

Managing uncertainty. Managing stress.

And in the middle of all of this… there are siblings.

Many parents tell me: “I worry about my other child too—but I’m not always sure what they need.”

The Quiet Strengths of Siblings

Siblings of children with CHD often develop incredible strengths.

They can be deeply empathetic.

Mature beyond their years.

Independent, responsible, and achievement-oriented.

Many grow into thoughtful, compassionate individuals in ways that are shaped by their family experience. But those strengths may not tell the whole story.

The Part That’s Easier to Miss

Siblings are part of the same family system—and they are impacted by CHD in ways that aren’t always visible. Family life may revolve around:

• Medical appointments and hospital stays

• Unpredictable schedules

• Financial stressors

• Health-related anxiety

• Shifts in attention and availability

Even when parents are doing everything they can (and they are), siblings may experience:

• Feeling invisible at times

• Confusion about their role in the family

• Guilt for having needs—or for not “having it as hard”

• Pressure to be “the easy one”

• Worry about their sibling’s health or future

Research on siblings of children with chronic illness and disabilities consistently highlights these themes, including feelings of invisibility, internalized pressure, and the importance of feeling understood and supported.

Risk… But Not the Whole Story

It’s important to say this clearly:

While siblings of children with CHD are at increased risk for emotional or behavioral challenges, not all siblings struggle. Outcomes vary widely based on:

• The severity and stability of the CHD

• Family stress and support systems

• The sibling’s age and personality

• Their own developmental or mental health profile

• The roles they take on within the family

In fact, supportive relationships—within the family and outside of it—are powerful protective factors. And accessing therapeutic resources for siblings of children with CHD can also be very helpful.

What It Can Look Like (Across Development)

Siblings don’t always say, “I’m struggling.” More often, it shows up in behavior or subtle changes. You might notice:

• Increased irritability or emotional outbursts

• Withdrawal or wanting to stay “under the radar”

• Changes in school performance

• Anxiety (especially about health or separation)

• Physical complaints like headaches or stomachaches

• Taking on too much responsibility—or avoiding it altogether

Some children act out. Others become very quiet. Both can be signs that something needs attention.

The Role of Identity and Family Roles

As children grow, they begin to understand their place within the family. For siblings of children with CHD, this often includes unspoken roles:

• The “easy” child

• The “helper”

• The “responsible one”

While these roles can look positive on the surface, they can also limit a child’s ability to express their own needs. Over time, siblings may begin to ask themselves:

• Where do I fit?

• What is expected of me?

• Is it okay for me to struggle too?

These are important questions—and they deserve space.

What Parents Can Do (Without Adding Pressure)

Supporting siblings doesn’t require perfection or balance (which often isn’t realistic). It’s about small, intentional moments over time.

Connection matters most.

One-on-one time—even brief, simple, and imperfect—helps your child feel seen for who they are, not just their role in the family.

Open communication matters.

Create space for honest conversations. Not every feeling needs to be fixed—but it should be acknowledged.

All feelings are allowed.

Siblings may feel love and pride, but also feelings that can be hard to accept – like frustration, jealousy, resentment, and worry—sometimes all at once.

Model emotional openness.

How you talk about stress, uncertainty, and coping teaches your child how to do the same.

Watch for patterns, not moments.

All children have ups and downs. It really matters when feelings or behaviors or impacting daily life. Do you have concerns about school, relationships, self-esteem, or independence?

Building a Support System Around Your Child

You don’t have to do this alone—and your child shouldn’t either. Support can come from:

• Your cardiology team (ask for sibling support resources)

• Teachers and school counselors

• Mental health providers (therapists, psychologists)

• Coaches, mentors, or trusted adults

• Peer relationships and community groups

Sometimes, simply having another adult who “gets it” can make a meaningful difference. Other times they need to be with peers who share a lived experience – to connect in ways that no one else can provide.

A Note About You (Because It Matters)

Parents often carry the weight of trying to meet everyone’s needs. And these needs can be competing. But supporting your children—including siblings—also means taking care of yourself.

Self-care doesn’t have to be big or perfect. It can be as simple as making space for your own thoughts, feelings, and limits. You’ll hear this again and again because it is so incredibly important to find a way to make this a priority.

Because when you’re supported, your whole family benefits.

Final Thoughts

Siblings of children with CHD are often doing more than we realize.

They are adapting. Watching. Understanding. Helping. Holding things quietly.

When we make space to see them—not just as siblings, but as children with their own experiences—we give them something powerful: The message that they matter too.