Paediatric palliative care is defined as care initiated as of the diagnosis of an illness limiting or jeopardising the life of a child. It can exist in parallel with curative care. It attempts to meet the physical, psychological, social and spiritual needs of the child with the primary objective of supporting the best possible quality of life in a family and interdisciplinary approach. Support in mourning is an integral part of this care.
Paediatric palliative care is addressed to children of all ages suffering from very diverse pathologies. The European recommendations of 2007 specified four groups of children who should be able to benefit from a palliative approach . Canadian teams had proposed two additional groups in 2006 .
The work of R. Hain et al. has enumerated slightly fewer than 400 different illnesses limiting life in children , while a British study estimates the prevalence of children with an illness limiting or jeopardising life at 10 to 16/10,000. Such data are unavailable for Belgium, and should be brought up to date. The development of modern medicine has in fact led to an increase in the prevalence of paediatric pathologies involving onerous management, with frequent hospitalisations and an adaptation of “care giving” at home. For these children suffering from Complex Chronic Conditions as defined by Feudtner in 2000, the palliative approach has developed both in hospitals and at home and in other living locations .
While the WHO definition  and the Belgian law of 2002 devoted to palliative care also apply to children, it must be realised that palliative care of children presents special features and poses a number of challenges for care teams :
Communication with the seriously ill child and his family (triangulation)
Pain management (evaluation approach related to the context and age)
Support of the extended family (parents and siblings)
Special features of care related to the diversity of disciplines and of ages (from the neonatal period to adolescence) and the small number of patients monitored (smaller critical mass than in adult palliative care)
Lack of experience of the first-line care teams in paediatric palliative care
The complexity and special features of paediatric continuing care fully justify giving paediatric palliative medicine a place in both general training of caregivers and multidisciplinary university training programmes .
 Steering Committee of the EAPC task force. IMPaCCT : standards for paediatric palliative care in Europe European J Palliat Care 2007, 14: 119-124. [pdf]
 Oriot D. Définition des soins palliatifs pédiatriques. Réseau francophone de soins palliatifs pédiatriques, 2006. [url]
 Hain R, Devins M, Hastings R, Noyes J. Paediatric palliative care: development and pilot study of a ‘Directory’ of life-limiting conditions. BMC Palliative Care 2013; 12;43. [url]
 Cochrane H, Liyanage S, Nantambi R. Palliative Care Statistics for Children and Young Adults. Health and Care Partnerships Analysis. Department of Health, UK 2007. [pdf]
 Feudtner C, Christakis DA, Connell FA. Pediatric deaths attribuable to complex chronic conditions: a population-based study of Washington State, 1980-1997. Pediatrics 2000, 106 : 205-209
 Organisation modiale de la santé, soins palliatifs [url]
 Liben S, Papadatou D, Wolfe J. Paediatric palliative care: challenges and emerging ideas. Lancet 2008, 371: 852-864
THE GROUPS OF CHILDREN
1. Children suffering from an illness for which curative treatments have failed (haemato-oncology, cardiology, nephrology, etc.)
2. Children for whom premature death is inevitable, but for whom long periods of treatment allow a certain quality of life (neuromuscular diseases, cystic fibrosis)
3. Children for whom care is solely palliative after diagnosis, but extends over a number of years (metabolic illnesses)
4. Children with severe neurological damage
5. Newborns for whom life expectancy is very limited (congenital anomalies, severely premature infants)
6. Members of a family who have unexpectedly lost a child in the perinatal period (stillbirths, abortions, medical interruptions of pregnancy, trauma)