When siblings feel left out because of IBD

When a child is diagnosed with inflammatory bowel disease (IBD), much of the family's attention naturally shifts towards their health and wellbeing. There may be more medical appointments, hospital visits, difficult days and changes to everyday routines. While parents are doing their best to care for everyone, siblings can sometimes feel left out or overlooked.

Siblings may understand that their brother or sister is unwell, but that does not mean they always understand why family life has changed so much. They might feel frustrated when plans are cancelled, disappointed when a parent cannot attend an activity or lonely when conversations seem to revolve around IBD.

These feelings can be difficult for parents to recognise, especially when they are already managing so much. However, helping siblings feel seen, valued and supported is an important part of caring for the whole family.

🫂 Why siblings may feel left out

IBD can create additional demands on a family's time, energy and emotional resources. During a flare, a child may need more help with symptoms, medication, appointments or hospital care. Parents may have less time and energy available for their other children, even when they are trying hard to keep things balanced.

Siblings may notice that their brother or sister receives more attention, has different rules or is allowed to miss certain responsibilities because of their illness.

They may experience situations such as:

• A parent missing their sports game because their sibling is unwell.

• Family outings being cancelled at the last minute.

• Conversations at home frequently focusing on symptoms, medication or appointments.

• Having to wait while their sibling receives care or attention.

• Being expected to understand, share or give up things because their sibling has IBD.

• Feeling that their own problems are less important by comparison.

Sometimes, the issue is not one major event but lots of small disappointments that build up over time.

A sibling may know that their brother or sister cannot help being unwell and still feel upset about how it affects their own life. Both feelings can exist together.

🥺 Signs a sibling may be feeling overlooked

Not every child will tell their parents directly that they feel left out. Some may not fully understand their emotions, while others may worry that expressing their feelings will make their parents more stressed.

Instead, their feelings may appear through changes in behaviour.

You might notice that your child:

• Becomes more irritable, argumentative or emotional.

• Seeks extra attention or interrupts conversations about IBD.

• Withdraws from family activities or spends more time alone.

• Complains that things are unfair.

• Becomes unusually quiet or tries not to cause trouble.

• Seems less interested in sharing their own experiences.

• Worries about their sibling but also expresses frustration with them.

• Develops physical complaints, such as stomach aches, particularly during stressful periods.

Some children respond in the opposite way. They may become very independent, appear unusually mature or avoid asking for help because they do not want to add to their parents' responsibilities.

These signs do not automatically mean a child feels neglected. However, they can be an opportunity to check in and ask how they are feeling.

💭 Why siblings may hide their feelings

Some siblings feel guilty about being upset because they know their brother or sister is dealing with a chronic illness.

They may think that their own problems are not important enough to mention, particularly when their sibling is experiencing pain, fatigue or a difficult flare.

Others may worry that admitting they feel jealous or frustrated will make them seem unkind.

A child might think:

• "Mum and Dad have enough to worry about."

• "I shouldn't complain because my brother is the one who's sick."

• "If I ask for attention, I'll make things harder."

• "Why does everyone always talk about IBD?"

• "I wish things could go back to how they were."

Children do not always have the words to explain these thoughts. They may simply feel sad, angry or disconnected without understanding why.

Reassuring siblings that they are allowed to have difficult feelings can help them feel safer talking about their experiences.

❤️ How to make each child feel important

You cannot always divide your time equally, especially when one child has medical needs that cannot wait. However, you can look for ways to help each child feel that they matter.

The aim is not to make everything perfectly equal. It is to make sure each child feels loved, valued and included.

Make individual time a priority

Try to spend some time with each child individually, even if it is only 10 or 15 minutes. Let them choose an activity, such as playing a game, going for a walk, reading together or chatting before bed.

Regular, predictable time together can be more reassuring than occasional big outings.

Show interest in their world

Ask about their friends, school, hobbies and worries. Remember important events and follow up afterwards.

When a child shares something with you, try to give them your attention rather than immediately returning to discussions about their sibling's health.

Keep their activities important

Where possible, try to attend their sports games, performances, birthdays and other special occasions. If you cannot attend because of an unexpected flare or appointment, acknowledge their disappointment and look for another way to celebrate or show your support.

Avoid making them feel responsible for your stress

Siblings may already be aware that their parents are tired or worried. Reassure them that they do not need to be extra good, independent or helpful to make family life easier.

Notice their achievements

Celebrate their efforts, milestones and successes. They should not have to achieve something extraordinary to receive attention or praise.

Small, consistent gestures can help siblings understand that their lives and experiences remain important.

💬 Talk openly about their feelings

One of the most helpful things parents can do is create opportunities for siblings to talk honestly about how IBD affects them.

You do not need to wait until there is a problem. A quiet conversation during a walk, at bedtime or while doing an activity together can make it easier for a child to open up.

You might ask:

• "How have things been feeling at home lately?"

• "Do you ever feel like I spend more time helping your brother or sister?"

• "Is there anything you miss doing together as a family?"

• "Have there been times when you've felt left out?"

• "What could I do to help you feel more included?"

Listen without immediately explaining why something happened or trying to fix the situation.

If your child says they feel ignored, resist the urge to respond with how much you have been juggling. Your responsibilities may be real, but their feelings are real, too.

You can acknowledge both by saying that you understand why they feel disappointed and that you will try to find ways to spend more time together.

Most importantly, let them know that they can be honest without hurting your feelings.

🩺 Explain IBD without making it the centre of everything

Understanding IBD can help siblings make sense of why their brother or sister sometimes needs extra care.

Explain that Crohn's disease and ulcerative colitis are chronic conditions that can cause symptoms such as abdominal pain, diarrhoea and fatigue. Symptoms can change over time, and a child may need more support during a flare than when they are feeling well.

You can also explain that IBD is not contagious and that their sibling has not done anything to cause it.

Keep explanations appropriate for their age and allow them to ask questions. Some children may want to understand the medical details, while others may simply want to know why a family plan has changed.

However, avoid making siblings feel that they must always understand, accept or accommodate everything because of IBD.

They can understand why their sibling needs extra care and still feel disappointed when something important to them is affected.

Both experiences deserve recognition.

🤝 Avoid expecting siblings to always be understanding

It can be tempting to rely on a sibling who seems mature, independent or particularly understanding. They may willingly help with small tasks or accept changes without complaining.

However, being understanding should not become an expectation that prevents them from expressing their own needs.

Siblings should not regularly have to miss out on activities, take on adult responsibilities or suppress their feelings because their brother or sister is unwell.

It is reasonable to encourage kindness and cooperation, but the responsibility for managing IBD belongs to the adults and healthcare team, not to a child's sibling.

If your child helps out, acknowledge their contribution and make sure they still have time for their own interests, friendships and responsibilities.

They should be able to enjoy being a child rather than feeling that they must always be the easy one.

📅 When family plans have to change

One of the difficult realities of IBD is that symptoms can be unpredictable. A child may feel well in the morning and become unwell later in the day. Hospital appointments may run longer than expected, and flares can disrupt plans with little warning.

For siblings, repeated cancellations can be disappointing, particularly when they have been looking forward to something special.

You may not always be able to prevent these situations, but how you respond can make a difference.

Try to:

• Acknowledge the disappointment rather than expecting them to accept it immediately.

• Explain what has happened in a way they can understand.

• Avoid promising that plans will definitely go ahead when you are unsure.

• Look for alternatives when possible, such as another trusted adult attending their activity.

• Arrange a replacement activity when it is practical, without making it feel like a reward for being patient.

• Keep some family traditions that can continue even during difficult periods.

If one parent or another trusted adult is available, consider whether they can take the sibling to their planned activity while the other parent supports the child with IBD.

Not every situation will allow this, but having a backup plan for important events can reduce the impact of unexpected changes.

🌟 Help siblings maintain their own identity

When a family is managing a chronic illness, it can be easy for IBD to become a major part of family life. Appointments, symptoms, medication and treatment decisions may dominate conversations and planning.

Siblings need opportunities to develop their own interests, friendships and sense of identity outside their brother or sister's condition.

Encourage them to pursue hobbies, spend time with friends and participate in activities they enjoy. Take an interest in their goals and experiences without comparing them to their sibling.

If one child needs more support academically or emotionally because of IBD, remember that siblings may also need help with their own challenges.

Their problems do not have to be as serious as a chronic illness to deserve attention.

Making room for each child's individual needs helps reinforce that every member of the family matters.

😔 What if a sibling becomes resentful?

Some siblings may express their feelings through anger, unkind comments or frustration towards the child with IBD.

This can be difficult for parents, particularly when they know how much their unwell child is already dealing with.

It is important to distinguish between allowing feelings and accepting hurtful behaviour.

You can acknowledge that your child feels frustrated while making it clear that teasing, blaming or deliberately upsetting their sibling is not acceptable.

For example, you might say that it is okay to feel angry about a cancelled outing, but it is not okay to blame their brother or sister for being ill.

Help them find other ways to express their feelings, such as talking to you privately, writing things down or taking some time away from a difficult situation.

Try not to label a child as selfish or unkind for struggling with the changes IBD has brought to family life. Their behaviour may be communicating a need for attention, reassurance or support.

If resentment becomes persistent or affects the children's relationship significantly, a family counsellor or psychologist may help everyone communicate more effectively.

🫶 When to seek extra support

It is normal for siblings to experience occasional jealousy, frustration or sadness when a family member has a chronic illness. These feelings do not necessarily mean they need professional help.

However, additional support may be useful if you notice ongoing changes in their mood, behaviour or daily life.

Consider seeking advice if your child:

• Seems persistently sad, anxious or withdrawn.

• Has ongoing difficulties with sleep or school.

• Frequently complains of physical symptoms that may be associated with stress.

• Becomes increasingly angry or hostile towards their sibling.

• Stops enjoying activities they previously liked.

• Expresses strong feelings of loneliness or worthlessness.

• Seems overwhelmed by worries about their sibling's health.

A GP, school counsellor, psychologist or family therapist can help assess what is happening and suggest appropriate support.

Support may also be available through local IBD organisations, which can help families connect with information and other people who understand the challenges of childhood IBD.

Seeking help early can make it easier for siblings to understand their feelings and feel more secure within the family.

💚 Remember, every child in your family matters

When a child has IBD, it is natural for their medical needs to require extra time and attention. There will be days when managing symptoms and appointments takes priority, and maintaining balance feels almost impossible.

That does not mean you are failing your other children.

What matters is continuing to recognise their needs, making time for connection where possible and reassuring them that they have an important place in the family.

Siblings do not need parents to divide every minute equally. They need to know that they are loved, that their feelings matter and that they do not have to hide their own struggles to protect everyone else.

You can care deeply for the child with IBD while also making space for the needs of their brothers and sisters.

IBD affects the whole family, but every child deserves to feel seen, valued and loved for who they are, not just for how well they cope with it.