If you plan on actually selling a game anywhere besides american adult stores, you can't have children getting killed in your game.
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Bloodborne has children in it, they can die. Game is rated M.
Pillars of Eternity has children in it, they can die. Game is rated M.
Fallout 1 and 2 have children in it, they can die. Both games still rated M.
The 90s movie The Blob a child not only dies but you can see his flesh just ripping off. Movie is rated R.
Fallout 3 you can kill two children in megaton by detonating the bomb. No one cares nor cries about it. Rated M.In Fallout 3 Sticky turns 16 and is old enough to leave lamplight. He can be killed. It is morally acceptable to kill 16 year olds just not 15 and under?Harvester has children in the game, they can die. There was even a scene of triplet kids eating a mother. Game is still rated M.
Bioshock 1 and 2 has children in it, they can die. Game is rated M.
Deadspace 1 and 2 has babies and children in it, they can die. Game is rated M. (Dead Island pussied out on this, they were going to do the same thing like in their trailer.)
Deus Ex 1 and 2 children can die in it. Game is rated M.
this is how wars are fought now by children hopped up on drugs and wielding ak-47s children have become soldiers of choice
This is how some countries win their battles because people's emotions get in the way and they can't see reality.
It's actually not illegal in the U.S. to make a game where children can die. Also a game where children can die certainly wouldn't get the AO rating as long as the death of children is not the main focus.