Children are a unique cohort in any medical specialty, and in this chapter, we discuss the nuances of directing care for this population in the setting of intensive care. Using 12 quotations, the issues around the involvement of family broadly—including extended family—are explored, as well as their capacity to act as surrogate decision-makers. We reflect on navigating the management of children who are themselves parents and balancing hope with realistic expectations intergenerationally. The added layer of complexity in dealing with this group when the intensivist themselves is a parent is also discussed. Managing children in the intensive care is not for everyone, and working through some of these themes may help the reader to recognize whether it is an area right for them.