October is Breast Cancer Awareness Month. More than 5 million children in the U.S. have a parent battling cancer — a population larger than the entire state of Alabama. Yet there isn’t a playbook for how to approach the subject with kids. Parents or guardians sometimes under-share to protect their children, while friends and family may avoid the topic altogether. When it comes to helping kids cope emotionally, many adults aren’t sure what to say or how best to support them. Sure, a casserole conveys love, but how do we really “be there” for the child?

We reached out to Amy Boan and Chris Nielsen of Kesem, a nonprofit that has supported more than 100,000 children facing a parent’s cancer through its free support programs and camps, and Hilary Hodge, founder of The Art of Parenting While Sick, which helps parents and guardians navigate conversations and family life while living with serious health conditions. Here, they offer concrete, practical ways to support children through a parent or guardian’s cancer diagnosis.

Be upfront about what’s going on

Kids tend to have “spidey senses,” says Nielsen. Even before adults say anything, they often sense that something is off. Nielsen knows this firsthand: His wife was diagnosed with cancer six years ago, and he says they waited too long to tell their son.

“If you’re not having a productive conversation about what’s going on … they’re going to start inventing stories in their head — and they’re usually scary ones,” says Nielsen.

Parents and guardians may instinctively hold back information to protect their kids, but “that can actually lead to more confusion and more questions,” adds Boan.

Boan also speaks from experience. Her father was diagnosed with multiple myeloma when she was a teenager, and, wanting more information, she had to look up the disease on her own.

It’s important to share age-appropriate information about what’s happening. Hodge recommends a five-step approach: explain what’s happening and the treatment plan, reassure children that their parent is in capable hands, prepare them for how the illness may affect everyday life and make clear what — if anything — is expected of them. The goal is to give kids information and a sense of safety without making them feel responsible for taking care of their adult.

Even if parents and guardians don’t know the full picture yet, they can tell their children what they do know. “The critical piece is to pair information with reassurance,” Hodge explains. She calls it the “P&J” method: peanut butter for information, jelly for reassurance.

For younger kids, conversations should be simple and concrete. Hodge offers this script: “I have cancer, and the doctors are going to give me medicine to help treat it. You can’t catch it, and no one caused it. It just happened. You can give me hugs and kisses in the next few days to help me feel better.”

They should also be ongoing, not a one-time event, says Hodge. “It can become part of the fabric of daily life, especially if the family has weekly or monthly meetings about it.”

Pay attention to what they aren’t saying

A child’s distress may show up as withdrawal, clinginess, anger, changes in eating or sleeping patterns and irritability. Hodge suggests canceling plans and slowing routines for extra together time. If behavioral changes persist or begin interfering with daily life, seeking professional support can help.

Sometimes we tell kids to “be brave” or “don’t worry, your parent is a fighter.” But these expressions don’t leave space for true emotions. Nielsen suggests simple, straightforward reassurances, like, “It’s OK if you’re scared or sad. And if you want to talk to me about it, I’m here for you.”

Helping kids feel heard and seen is really the “name of the game,” he says. Nielsen believed his son had taken his mother’s cancer diagnosis well but eventually realized he was burying his emotions and needed help unpacking them.

Let kids be kids

These kids aren’t just grieving kids — they are kids, Boan reminds us. Yes, they are dealing with this “huge thing,” she says, but they also need space to have fun, play and be themselves.

During her father’s cancer treatment, Boan’s aunt would take her for pedicures —something fun and “separate from everything else” she was carrying.

Today, Kesem supports kids ages 6 to 18 who have been impacted by a parent’s cancer through Camp Kessem, a nationwide free, week-long sleep-away summer camp, as well as year-round resources such as virtual meetups.

Often, kids may feel isolated and unable to talk about what’s going on with their peers. Attending a camp where every kid is in the same boat is “incredible and powerful,” says Nielsen. “It creates very quickly those bonds and connections that when the kid’s feeling ready, they can start talking about cancer if they want to.”

Hodge recommends keeping a child’s world as predictable as possible, including school, playdates, sports and bedtime routines. Provide them small moments of control when everything else feels outside their control. She says simple gestures like choosing what’s for dinner or who will take them to practice can be comforting.

Parents and guardians shouldn’t have to provide all the stability alone. Family, friends, teachers, therapists or other trusted adults can help answer questions, maintain routines and spend time with the child.

“Just simply checking in and letting them know that you’re there” can be one of the most important things an adult can do.

So, bring the casserole. But remember the kid standing beside the person you brought it for.