Supporting your children's mental and emotional health

If you receive a breast cancer diagnosis, it affects your entire family, including children. Children of all ages can tell when you’re stressed, distracted, or not feeling well. They’ll also be aware of changes in family routines.

Children can have a wide range of responses and emotions when they learn a parent has breast cancer. How kids respond often depends upon their age and how much they’re able to understand. Not all children will have the same reactions, though, even at the same age or within the same family.

For example:

• Younger children may worry that they caused the cancer and wonder if they’ll get sick, too.
• Some children may be anxious or sad, while others may show little to no emotion.
• Children might share their feelings openly; or, they may withdraw and spend more time alone.
• Some children can become more clingy or dependent, while others might express their emotions by arguing more, losing focus at school, or sleeping poorly.
• Some may have lots of questions, but others may be content with the information you provide.

Below, we’ll share tips on how to prepare for the range of reactions your children might have, both after you share the diagnosis news and as you move through treatment. They might not respond in the way you expect, and they’ll need space to process their feelings and adapt to change. There are many ways you can support their mental and emotional health and help them manage their feelings.

What stresses and challenges might my child face?

Telling a child about a breast cancer diagnosis is helpful for many reasons. But they will also have concerns, questions, and emotions that may be hard to manage.

Kids’ feelings can vary depending on their age, maturity level, their personality, and how they’ve responded to difficult situations in the past. Some common stresses and challenges can include:

• Uncertainty about what’s going on with your health, and whether you could die
• Anxiety about being separated from you while you’re in treatment or recovering from treatments
• Concerns about who is going to be there for them while you’re in treatment — and, in some cases, who will care for them longer-term if you’re facing metastatic breast cancer
• Fear that they might have somehow caused the cancer
• Anxiety about whether they could be at higher risk for cancer, now or in the future
• Frustration about cancer’s impact on their life and everyday routines
• Anger about your reduced availability to help with schoolwork, attend performances and events, or do other things you normally do for them
• Irritability when asked to take on more responsibilities at home, such as chores or watching younger siblings, and having less free time as a result
• Feeling isolated from friends and peers who haven’t experienced a parent’s serious illness
• Feeling guilty about wanting to spend time with friends, have fun, and focus on their own lives while you’re not well
• Struggling to talk with others, such as friends, neighbors, or teachers, when they ask about the cancer and how you’re doing
• Feeling embarrassed about physical changes in your appearance, such as hair loss or eyebrow loss caused by chemotherapy
• Not wanting to upset you by asking questions about breast cancer

Guiding children through these challenging feelings, both on your own and with assistance from other trusted adults, can help them develop emotional strength.

Helping children find social and emotional support

Many children need a safe place to share their feelings about how your breast cancer diagnosis has changed their world. They may need support for distress they feel when first told about what is happening. They may also need support during your treatments, as you experience side effects such as hair loss or fatigue.

Teens may feel more comfortable sharing their fears and worries with friends, rather than with you.

As you talk about breast cancer with your kids, encourage them to share their feelings with others, including:

• Brothers and sisters
• Friends and teammates they trust
• Grandparents, aunts, uncles, cousins, and other relatives they’re close to
• A teacher, counselor, or coach

Family members, teachers, or other trusted adults can help by letting children talk about what they’re feeling, openly and without judgement. School guidance counselors can also provide space for children to talk about their worries or fears.

Some schools and hospitals offer support groups for children and teenagers who have a parent going through cancer. Summer camp programs are available as well. Your child might benefit from meeting other kids who know just how they feel.

Ask a hospital social worker or your child’s school counselor if they’re aware of any programs in your area. Other resources to consider include:

• Bright Spot Network
• Camp Kesem
• Wonders and Worries
• The Pickles Group

Communicating with your child’s school

Your child’s school can be a great source of support while you’re going through breast cancer treatment.

For children in preschool, kindergarten, and the primary grades, changes in at-home routines can be upsetting. For some kids, this might result in changes in behavior at school — from being quieter or more withdrawn to acting out or misbehaving.

By letting your child’s teachers know what is going on, they can keep an eye on your child and provide extra support as needed. If your child wants to talk to an adult they trust, a teacher can fill that role. Teachers also can keep you informed about what they’re seeing during the day, in case there are dramatic changes in behavior that you’re not seeing at home.

Check in with middle schoolers and high schoolers before you share the news with their counselor or advisor. For example:

• Some preteens and teens might prefer to keep school a “cancer-free” zone where they aren’t asked questions about what’s going on at home.
• Others might want the school to know in case preteens or teens need extensions or extra support to get caught up with schoolwork and tests.

You know your child best. Talk to them about your plans to share the news with their school.

If you see unusual changes in your preteen’s or teen’s behavior, such as slipping grades, sleeplessness, or anxiety, it’s often best to let their counselor or advisor know what‘s going on at home. They can keep this information confidential while also watching out for your child’s best interests and providing extra support if they need it.

To learn more, visit 6 ways to partner with your child’s school during your breast cancer treatment journey.

When to seek professional help

With extra support at home and school, many children and teens do just fine when a parent has cancer. Many become more resilient and independent, growing stronger as a result of the experience.

However, some children may benefit from working one-on-one with a mental health professional, such as a psychologist, psychiatrist, social worker, or licensed professional counselor.

If you notice significant changes in your child’s behavior that last a couple of weeks or more, talk to their pediatrician and/or school about sources of professional help. Changes in behavior could include:

• Excessive anger or worry
• Withdrawing from hobbies, sports, or social activities
• With younger children, regression to past behaviors, such a bedwetting or tantrums
• Physical symptoms such as stomachaches, headaches, or fatigue
• Trouble sleeping
• Clinginess and separation anxiety
• With teens, acting out in risky ways, such as physical aggression, self-harm, substance use, disordered eating, reckless driving, and unsafe sexual practices

In age-appropriate ways, talk to your child about what it means to see a mental health professional. Let them know that a professional can be a positive, helpful resource for them, listening and providing a supportive, private place to talk through distress and any tough feelings. Your child will have a place to process their emotions and talk about them in a constructive way.

If your child is a worrier, prone to anxiety, or has trouble expressing feelings, consider getting professional help sooner rather than later. Seeking help early can benefit certain children in the long run.

Talk with your pediatrician, oncology social worker, or school counselor for referrals and recommendations. Ask for a referral to a professional mental health counselor who works with children who have parents diagnosed with cancer. Many therapists, such as psychologists, work in hospitals, cancer centers, or in counseling service agencies.

Keep in mind that there can be long waits for pediatric and adolescent mental healthcare, and it is not always covered by insurance. If you face these challenges, see if your children’s school has a psychologist on staff who can help.

Recommended resources

These additional resources may be helpful as you continue to support your children:

• Helping Children When a Family Member Has Cancer, American Cancer Society
• Talking to Children About Your Cancer, National Cancer Institute
• When Your Parent Has Cancer: A Guide for Teens, National Cancer Institute
• 10 Ways to Support Children Through a Parent’s Cancer Diagnosis, National Breast Cancer Organization
• Parents With Cancer program, Dana-Farber Cancer Institute

For books that can be helpful for children, check out our free books program.

Taking care of your own emotional health

Managing a cancer diagnosis, treatment, and your children’s well-being is an intense and overwhelming experience. It may not feel natural to prioritize your own needs over your children’s, but it’s important to find time to take care of yourself and your health. Taking care of your own needs can ease stress and preserve your energy.

Caring for yourself can be as simple as:

• Asking a relative to take the kids for a few hours
• Taking a short walk with a friend
• Going to see a movie
• Attending an event that interests you
• Eating healthy foods

Asking for help is another way to take care of yourself. This can be hard to do sometimes, but there are ways to make it easier. Visit Caring for your mental and emotional health to learn more.