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Getting a Divorce? Considering it? Tell a Pediatrician.

Even amicable divorces are wounds for kids and their doctors help them heal.

Parents often make the choice to divorce when they realize that their unhappy marriage isn’t healthy for them or their children, but there’s still no such thing as a clean break when kids are involved. “This is a wound and depending on how the wound is cared for it can get infected and spread and cause major systemic damage,” Don Shifrin, clinical professor pediatrics at the University of Washington and Fellow of the American Academy of Pediatrics, told Fatherly. “Or it can be healed as rapidly as possible, but it is still going to leave a scar.” This is a rather harsh way of making a good point: There are children’s health implications to divorce so parents should talk about it with their child’s physician.

READ MORE: The Fatherly Guide to Divorce and Kids

Depending on a child’s developmental stage, divorce can cause problems with potty training, separation anxiety, sleep disturbances, struggle with concentration problems, have stomach problems, compromised immune systems, Shifrin says. Research similarly shows that illness can be correlated with parental splits. Some studies even suggest that children of divorce may have shorter lifespans comparatively. This makes it all the more vital for pediatricians to be kept in the loop about parents’ fractured relationship status, no matter how uncomfortable it may be to communicate that — especially in front of a child who’s already upset about it.

“Pediatricians can take the temperature of what’s happening in the house and apply some psychological acetaminophen or Tylenol to the situation to calm it down a bit,” Shifrin says.   

Although there’s no best way to do this, there are better ways, Shifrin says. On the better end of the spectrum, if a child is old enough to be left alone, a parent will sometimes ask them to step into the waiting room. Then the parent will ideally discuss the divorce with their pediatrician before they tell kids. This gives them the opportunity to give parents feedback on how to best communicate this to their children while making them aware of a huge change that will affect their patient’s health. Another option is calling doctors before coming in to do this, and though email is still a relatively rare way to do this, Shifrin suspects it may become a more common option in time.

For parents do not preemptively inform pediatricians and collaborate on how to break the news to their children, telling doctors as soon as possible is imperative. But occasionally parents keep this to themselves and Shifrin will find out up to a year or two after the divorce, when a child is brought in for something routine, like a sports physical. “I’ll make a generalization, ‘is dad still working at so-and-so?’ and they’ll say ‘no, dad is out of the house.’ And then there’s a long pause.” This puts doctors in a bind where they very quickly have to gauge whether asking more questions will be more helpful or harmful to their patients. In these instances, Shifrin will follow up by phone after the appointment to attempt to fill in a significant information gap relative to the child’s health. Although it’s better than not knowing at all, this is not ideal for doctors.

Pediatricians can help facilitate this difficult process by listening, empathizing, and reassuring families that this is a difficult situation that’s not going to be solved in the short term. However, when parents ask doctors to go as far as to explain what divorce is, they must set boundaries as well. “I have told parents privately that this is not a role for a pediatrician. This is a family issue that should be explained by someone they love.”

It’s also important for parents to realize that their children were likely exposed to this relationship long before the decision was made to divorce. Whether or not they’re old enough to understand what they’re observing does not change that they feel the strain instinctually and are inevitably affected by it. Ultimately even the most amicable of divorces can be a crisis for kids, and it’s important for parents to remember that they’re their kids first responders, Shifrin says. Mothers and fathers can’t respond when they refuse to talk about it, and that makes kids sick.

“Your anger, your frustration, your irritability, and your vulnerability — it is a contagious disease to your children. It’s going to impede their resilience.”