A purple butterfly in a hospital, usually a sticker on a baby’s cot or isolette, signals that the infant was born as part of a multiple pregnancy (twins, triplets, or more) and that one or more of the siblings did not survive. It’s a quiet, visual cue designed to protect grieving families from painful questions like “Where’s the other baby?” while also alerting staff to approach with extra sensitivity.
Where the Symbol Came From
The purple butterfly traces back to a British mother named Millie Smith. Twelve weeks into her pregnancy with twin girls, Millie learned that one of her babies, Skye, had a condition called anencephaly, where the skull does not properly form. Skye was expected to live only seconds after birth. She was born alongside her twin sister Callie at Kingston Hospital on April 30 and died just a few hours later.
In the days that followed, Millie found herself fielding questions from well-meaning visitors and other parents on the ward who didn’t know about Skye. She felt there should be a small, discreet symbol to let people know her baby had died, and she landed on a butterfly colored purple so it could represent a boy or a girl. Her local hospital adopted the idea, and Millie and her fiancé Lewis went on to create the Skye High Foundation, a charity supporting bereaved families. The concept spread internationally and is now used in hospitals across the UK, the United States, and beyond.
How Hospitals Use It
The specifics vary by hospital. At Massachusetts General Hospital, staff place a purple butterfly sticker on the isolette or bassinet when a baby who was part of a multiple pregnancy passes away. At Nationwide Children’s Hospital, the butterfly goes on the door of patients who lost a sibling. The stickers honor babies lost at any stage: in utero, stillborn, or after birth.
The symbol serves two audiences at once. For the family, it’s a way to acknowledge the baby who died and create a small, visible legacy. As one clinician at Mass General put it, “The child has an ongoing life after death and the butterfly is a marker for that.” For hospital staff, it works as a non-intrusive reminder. Nurses, doctors, cleaning crews, and social workers can all see the butterfly and understand the context before they walk in the room, which helps them avoid accidentally saying something hurtful.
Why a Simple Sticker Matters
Losing a baby during a multiple pregnancy creates a uniquely painful situation. Parents are simultaneously celebrating a surviving child and mourning a child who died. Other families in the maternity ward may not know, and even basic small talk (“Just the one?”) can be devastating. The butterfly handles this without forcing anyone to explain their loss out loud, over and over again.
A quality improvement study published in the American Journal of Hospice and Palliative Medicine tested a similar purple butterfly communication tool and found striking results. Nine months after implementation, 100% of surveyed staff members reported they were always aware when a patient was receiving comfort care before entering the room. Every respondent also said that having this contextual information helped them do their jobs in a more compassionate, patient-centered way. Before the system was in place, that awareness was inconsistent, which meant families were more likely to encounter staff who didn’t understand the situation.
What to Do If You See One
If you notice a purple butterfly sticker on a baby’s cot, bassinet, or room door, it means the family nearby has experienced a loss. You don’t need to say anything about it. The most helpful response is simply to be mindful: avoid questions about how many babies the family has, don’t make assumptions about their situation, and follow the lead of the parents if they choose to share.
If you’re a family member or friend visiting a loved one who has a purple butterfly on their baby’s cot, it can help to know what it represents so you can offer support without waiting for the parents to bring it up. Some families want to talk about the baby they lost. Others aren’t ready. The butterfly gives them the space to grieve on their own terms, without having to explain.
Other Color-Coded Symbols in Hospitals
The purple butterfly is one of several color-coded visual cues hospitals use to communicate sensitive information quickly. Some hospitals use different colored butterflies or symbols for other types of bereavement. A leaf or teardrop on a maternity room door, for instance, may indicate a stillbirth or neonatal loss that didn’t involve multiples. These symbols vary widely from one hospital to the next, so the meaning of any particular marker depends on the facility’s own protocol. The purple butterfly specifically tied to multiples loss is the most widely recognized version, thanks to the Skye High Foundation’s international reach.