OBJECTIVE: To examine the place of recent and historical pictorial representations of the dead baby and their relevance to the current care of grieving parents. DESIGN: A selective review of the literature on representations of the dead baby. Visual examination of seven paintings (1550-1676) in order to understand their meaning. FINDINGS: In the late 20th century the practice of taking photographs of the baby who had died became widely accepted. In the 16th and 17th centuries grief at the loss of a baby could be portrayed in the form of paintings. There are similarities between photographs currently being produced and the paintings produced four centuries ago. At both times grief could be expressed through religious rites and naming the child. Although some portrayals have been naturalistic, this has often not been the case. Paintings gave parents an opportunity to ‘count’ the child as part of the family. KEY CONCLUSIONS: These paintings suggest that a practice recommended as innovative in the late 20th century may have had a long history. Historically, families had a healthier attitude towards the death of a baby than in the mid-20th century. It is suggested that the difficulty of facing death, on which midwifery care of the grieving mother was, until recently, based may have been a temporary aberration. IMPLICATIONS FOR PRACTICE: The sensitive care of the grieving parents has a long and well-authenticated history.