Siblings of a child diagnosed with CSID may experience negative emotions. Some of these emotions may be:


  • Feeling left out or jealous. Parents/caregivers may inevitably focus their energies on the child with CSID and thus, other children in the home have to deal with parents/caregivers being less available, both emotionally and practically. This is especially true at the time of diagnosis since a CSID diet can be difficult to figure out and incorporate into the rest of the family’s routine.
  • Resentment or bitterness. Siblings may sense that there is a “special” relationship between the child with CSID and the parents/caregivers because of the time spent focusing on the CSID diet and routine. Make extra efforts to spend quality time with all children in the household on a regular basis. Be sure and send the message that a diagnosis of CSID does not put one child above or below the others. For siblings not affected by CSID, try to engage in activities that are meaningful to that child whether it be reading a book together, playing sports together, or going out for a treat.
  • A sense of guilt, thinking, “Why him and not me?”  They may also feel guilty if they ever have bad feelings toward their sibling with CSID. Allow the sibling to talk through his/her emotions, while offering emotional support.
  • Anger at the situation, thinking, “Why us?  Why our family?  It is not fair.”  Reassure your child that this is normal and help him deal with it effectively. Help the sibling feel angry at the disorder, not at his/her brother or sister.
  • Embarrassment when others notice the different diet and symptoms of the child affected by CSID. Because the child with CSID eats differently than other children, this may bring unwanted attention to the family. Other children may tease a child with CSID, which could bring embarrassment to the non-CSID sibling. Help the sibling learn how to effectively deal with this embarrassment. Counseling or support groups for families dealing with chronic disorders are available in some areas.


Allow siblings to take turns making typical family choices such as TV programs or what the family may do for an outing. Additionally, if a sibling does not have CSID, they should not be required to adhere to a restricted diet themselves or be penalized because another child in the family has CSID. However, it can be beneficial to create at least one family meal with as much common ground as possible so the child with CSID feels included at family mealtimes. Maintaining a sense of fairness and understanding will engage all the children to support one another. Accepting human differences and limitations while celebrating strengths with compassion is a life lesson for all.


There are positive aspects of having a family member with a chronic condition. Non-CSID siblings have ample opportunities to develop increased empathy, adaptability, responsibility, and problem-solving skills. These are all desirable traits that could be highlighted to a sibling who is having a hard time dealing with the realities of CSID. Involve the CSID child and affected siblings in creating family goals and reassessing them periodically. The goal should be for CSID to bring the family closer together, not tear the family apart.