It is becoming increasingly acknowledged that palliative care involves much more than terminal care alone. Many of the principles and fundamental tenets of palliative care can be applied early in the course of chronic conditions to help families live better with their child’s fatal disease. Opportunities for professional development and liaison with experienced palliative care providers can assist paediatric health professionals who deal with children and parents at various points in the illness trajectory, so that the experience of care is improved. The early establishment of effective communication, trust, and a supportive therapeutic environment that is inclusive of community providers facilitates effective palliative care later on. A key function of the health professional is to offer ongoing support through all phases of the child’s illness and through all of the transitions that the family makes. It cannot be overstated that it is the quality of the relationship between families and health professionals that is fundamental to meeting the challenge of the many transitions that are faced in paediatric palliative care.