Patterns of successful and unsuccessful resolution of grief over death of a child were studied in 25 families who had lost children across an 11-year-span. The families varied considerably in age, income, education, and parental occupation. Data were gathered by means of an intensive, open-ended interview schedule. The research focused on two questions: (1) what processes seem to need to occur within the family for successful replacement of a child? (2) what are the effects on the new child if these processes are unsuccessfully resolved? Whether replacing the child helps or hinders the family system is intimately bound to grief resolution by parents, siblings, and supportive systems. The tasks of resolving anger and guilt, accepting the death of the child, and forming a new steady state within the family were determined by parents' personality structure, past experiences, circumstances associated with the loss, and the pressures exerted on parents from the systems of which they were a part. Essentially, acceptance of the new child depends on parents' adequately resolving their grief and developing new communicational and relationship patterns in the family. (Author/DB)