Butterfly cot card, produced by Neonatal Butterfly Project, Newcastle, England, 2016. Cards used on neonatal intensive care units to indicate when a baby has lost one or more siblings.

Neonatal intensive care is a busy, intense environment and good information sharing is key. This purple butterfly is used, with families’ consent, to indicate that a baby was part of a twin or multiple pregnancy but had siblings who died before, during or after birth. The researchers behind the Neonatal Butterfly Project found that it was particularly difficult for many families in this situation if the healthcare professionals working with their family did not know about or acknowledge their loss. For example, many parents reported that well-meaning attempts to be positive by focusing only on the surviving baby underestimated their grief.

These cards were first introduced by the Neonatal Butterfly Project in 2015 and they were inspired by the work that the researchers had done with bereaved families.