Photographic art can express deep human emotion and often is used to help parents with bereavement. Parents who have experienced infant death state that photographs are important to prove that their child did exist and to remember the child as an individual within a family. Although parents confirm the importance of photographs, actual empirical evidence for the effect of photographs on healing is lacking (Alexander, 2001). Despite this lack of research evidence, empirical evidence from decades of bereavement practice has led to the inclusion of photographs as a part of pediatric palliative care protocols, along with suggested approaches for natural and sensitive photographic arrangements (Meredith, 2000). Digital technology can improve photographic quality and access for parents at a time of loss.

BereavementPhotography

Visual art of infant death is not a recent development. Paintings in the 16th and 17th centuries documented infant death as a part of family life (Mander & Marshall, 2003). These family portraits included dead siblings (tightly swaddled, with a garland crown, or with eyes closed) next to surviving infants. Photography was used to document infant death in the early 20th century (Meredith, 2000).

Although perinatal bereavement photography is common today, parents often regret not having better quality photographs. Grieving parents need caregivers to guide them in their options, which may include photography by the nurse, medical photographer, or professional photographer. The "instant prints" (Polaroid) are recommended only for an immediate tangible picture, because the image is not reproducible and will fade. Professionals choose 35-mm film or digital media for lasting portraits and most often choose black and white portraits. With digital technology, photographers can accomplish remarkable photo retouching and creative options. Recently, a friend who lost her son at birth years ago had his only photograph digitally retouched by a professional photographer into a high-quality portrait.

Online Resources

Nurses can help parents and other caregivers locate bereavement photographers online using the sites described here or by searching the term "bereavement photography." One of the sites I recommend is Now I Lay Me Down To Sleep (NILMDTS) (http://www.nowilaymedowntosleep.org), a nonprofit organization formed in 2005 to support parents who experience an early infant loss. The Web site describes and illustrates digital bereavement photography (still photos with music accompaniment), lists contact information for a growing network of volunteer professional photographers, and sponsors a discussion forum. The forum posts testimonials, including one from a pediatric intensive care nurse thanking the organization for supporting the family of a 2-month-old infant. The organization also aims to develop photographers' sensitivity and compassion in this emotional situation. The family receives the photographs and a digital file at no cost.

Touching Souls (http://www.toddhochberg.com) is the Web site of Todd Hochberg, a professional photographer who also provides portraits at no charge to the grieving family of an infant or child. This Web site describes "documentary style bereavement photographs" and illustrates the art form with photos that journal the stories of adults coping with cancer. Hochberg has conducted hands-on workshops for caregivers, medical photographers, and professional photographers. Both sites display past newspaper coverage and how that coverage has served to expand the network for parents.

Visit these Web sites and consider bereavement photography as an intervention in your perinatal or pediatric setting. You can be the professional who advocates for parents' choices about appropriate, long-lasting bereavement photography at this difficult time in their lives. You might also be the nurse who designs a research study to evaluate the effect of bereavement photographs on healing.

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