I don’t normally use content warnings on any of my posts. This is a site about funerals, embalming, death and grief. Most people know it’s going to sometimes be too graphic for their tastes, and can choose to avoid posts filed under “Embalming”, for example.
I get a lot of comments from people thanking me for describing embalming in such detail (hopefully they would say I was nothing but clinical in my descriptions). They say it gave them a small amount of comfort to read about what their loved one went through when he was prepared. Some people want to know everything.
But, I feel I must warn my readers that this post is about everything involved in embalming an infant, from the hospital pickup to the burial. If you or someone you know has lost a baby, you may not want to read this one. Or, you may find it valuable in assisting your grieving process. If it makes you cry, that’s probably okay. If it makes you throw up, it’s time to stop reading and be with someone who is supportive.
Most infants will be autopsied, but a few of them aren’t. My first and my most recent were not. But they will usually be picked up from a hospital or medical examiner. Medical examiner removals are done the same way as for anyone else, only the baby doesn’t go on a wheeled gurney. I carry a big blanket with me and just fully wrap the baby, then belt him in the front seat of my van. Some funeral homes use a bassinet, carseat, or large tote bag.
When picking up from the hospital, they will try to conceal the appearance of carrying a baby, because hospital removals are often done while walking through public walkways or using public elevators, and you don’t want people cooing over your precious baby, obviously.
Keep in mind, the parents may not yet have seen the baby. It could have been a surgical birth, or possibly a very difficult labor and delivery, and the mother may have been under anesthesia. If the parents are young, they might not be together. The father might not know his child has died, or that he had one. In the case of a teenage mother, her parents might also not be aware there was a baby, or they may be estranged from their daughter. She may have been kicked out of the house due to the pregnancy or to who the father was.
Sometimes the funeral arrangement will take place in the hospital delivery room, or the mother’s home, as she may not be up to taking a drive to the funeral home. This is something I offer to all families anyway.
Always assume there will be a viewing. When you get to the funeral home, coat the baby’s eyes and mouth – the exposed mucus membranes – with moisturizing cream so they don’t dry out and turn dark brown.
If the baby is autopsied, your job will be easier. The arteries are all right there; you just embalm the body as you would an adult, but you use smaller equipment and less fluid. Babies decompose very quickly so I use strong solutions, something like one bottle of a high-formaldehyde arterial fluid and half a bottle of a humectant. In the case of no autopsy, which is often the case with babies who die after hospital admission while under a doctor’s care, you will have to select an artery. Most embalmers will incise the abdomen and use the abdominal aorta, but I prefer the carotid, even on a very small newborn. The incision must be made very deftly; no pressing down on the blade. Just stroke the skin with it. I will suture with dental floss and not traditional suture thread. Luckily, since most babies don’t have very defined necks, the incision is easily hidden.
You will probably need a radial cannula; that is, a tube commonly used to inject the radial or ulnar artery of an adult. An infant carotid will be the same size. Since infants have no plaque built up in their arteries, you will probably be able to embalm them through a single injection point, and the fluid will take effect very rapidly. You will have to be vigilant about not over-embalming the tissues and swelling them, since many babies will arrive with swelled heads already, possibly due to drugs or procedures undergone in the hospital.
In the case of a very premature infant, arterial embalming is not possible and the baby can only be submerged. A plastic tub with one or two bottles of a strong fluid with added humectant should be sufficient. Leave the baby in this bucket overnight. The baby can then be dressed in doll clothes, or special clothes for preemies. There is even a company that recycles old wedding dresses to make clothes for babies of all sizes who have died.
Mouth closure might not be fully possible. Fortunately, you can usually leave the mouth open, and every day before the viewing, coat the lips and tongue with moisturizing cream to keep them pink. Many infants sleep with their mouths open, so the appearance will likely be natural and comforting to the parents. However, I explain this to them beforehand. I also don’t position them with their hands folded in the manner of an adult, because no infant will ever do that naturally. I usually prop them up in the casket similar to how they would lie in a carseat, and leave their arms at the sides. If they can clasp a toy, it often looks more peaceful. Sometimes the embalming fluid distends the arms and gives them the appearance of an uncomfortable position, and in that case, a blanket covering the infant to the chin might be needed.
I save everything that came with the baby. Clothes, hospital bracelets, locks of hair. I also take fingerprints, handprints, and plaster casts, if possible. Even something like the tabs off a diaper. That diaper may have been the first and only item of clothing the mother put on her child. Those hospital bracelets are some of the only mementos of his short life.
Babies do not last long after embalming, and as luck would have it, the parents tend to take a long time to arrange the funeral. You will most likely be meeting with families who are very intoxicated, angry, or too despondent to leave their homes or say much. And of course, at this stage of their grief, they do not want to and should not hear about how babies’ thin skin often leaks embalming fluid each day he remains in the funeral home cooler, or how often you have to reaspirate his nose. A baby in your care needs care every day.
Check the eyes and mouth every day. Use a thick coat of moisturizing cream, so thick you can’t see the mouth or eyes under it. Do the same with the hands. Check the incision for leaks. Check the diaper, they will leak everywhere. I don’t dress or casket an infant until it’s time for the viewing, and if there will be a second viewing, I undress the baby until it’s time for the next one. Otherwise they will leak embalming fluid on the clothes.
Viewing often includes picking up, which should be encouraged. This is another reason to be vigilant about aspirating and making sure nothing will leak from the nose. I explain to the family that the baby will feel like, well, a hard block and not a soft baby.
I recommend always taking a photo of the baby in the casket, ready to be viewed. This is because sometimes the mother will be so distraught she won’t want to look at the baby, and months or years later, she may regret it. At least we can show her the picture we saved.
Many funeral homes bury infants at cost, or at a discount, which of course is right. But keep in mind, if you are the one making the financial decisions, you will have to pay the embalmer, who will have to work for several hours to several days. I work for a flat fee and charge half my rate for an infant, but if your staff work for an hourly fee, it will get very expensive.
I am a very good embalmer of infants. I wish I didn’t have to be.