The coauthors, both adoptive parents, weave professional and personal experiences with essential information on:
• Partnering with a pediatrician before adoption
• Helping a child transition into a family
• Understanding health issues and conditions that are more prevalent in children who are adopted
• Supporting a child’s emotional health and attachment
• And promoting positive adoption conversation as a child matures
This comprehensive resource offers trusted parenting advice from a leading adoption medicine expert and the American Academy of Pediatrics, focusing on the physical and emotional well-being of adopted children.
The coauthors, both adoptive parents, weave professional and personal experiences with essential information on:
• Partnering with a pediatrician before adoption
• Helping a child transition into a family
• Understanding health issues and conditions that are more prevalent in children who are adopted
• Supporting a child’s emotional health and attachment
• And promoting positive adoption conversation as a child matures
This comprehensive resource offers trusted parenting advice from a leading adoption medicine expert and the American Academy of Pediatrics, focusing on the physical and emotional well-being of adopted children.
Caring for Your Adopted Child: An Essential Guide for Parents
212
Caring for Your Adopted Child: An Essential Guide for Parents
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Overview
The coauthors, both adoptive parents, weave professional and personal experiences with essential information on:
• Partnering with a pediatrician before adoption
• Helping a child transition into a family
• Understanding health issues and conditions that are more prevalent in children who are adopted
• Supporting a child’s emotional health and attachment
• And promoting positive adoption conversation as a child matures
This comprehensive resource offers trusted parenting advice from a leading adoption medicine expert and the American Academy of Pediatrics, focusing on the physical and emotional well-being of adopted children.
Product Details
| ISBN-13: | 9781610022156 |
|---|---|
| Publisher: | American Academy of Pediatrics |
| Publication date: | 10/15/2018 |
| Pages: | 212 |
| Product dimensions: | 5.90(w) x 8.90(h) x 0.50(d) |
About the Author
Robin Michaelson is a writer and editor who has worked on such bestselling titles as Caring for Your Baby and Young Child: Birth to Age 5 and The Happiest Baby on the Block. She is the mother of an adopted daughter and lives in Brooklyn, New York.
Read an Excerpt
CHAPTER 1
Getting Ready to Bring Your Child Home
Our adoption agency gave Andrew and me a list of American Academy of Pediatrics pediatricians who performed pre-adoption consultations. Before we adopted, I called several to see how easy it was to reach them and how quickly they returned my call. I wanted to make sure I felt comfortable talking with a doctor I'd never met before. A few weeks after I selected our doctor, we got a call from the agency — we were matched! The agency wanted us to review the baby's medical information and make our decision within a day. I was glad I had a doctor to reach out to. She called us back within a few hours, and she helped us make an informed decision.
— Gwen, mother of Hannah, a domestically adopted child
As a physician, I've been trained to always be ready for anything, and this trait is also a natural part of my personality. I like to prepare and plan so I know what's going to happen before it does. Of course, life doesn't always work like this, but I still believe that a certain degree of preparation for most situations can help relieve our anxieties. At least it helps relieve mine!
The Value of a Pre-adoption Consultation
While a pre-adoption consultation is not a required part of the adoption process, most adoption agencies recommend that prospective parents talk with a pediatrician who has expertise in adoption. The American Academy of Pediatrics posts a list of adoption medical specialists on its Web site (www.healthychildren.org/English/tips-tools/findpediatrician/ Pages/Pediatrician-Referral-Service.aspx). These pediatricians will review any medical records, photos, and video files of your child, and they will answer any questions you have. Please keep in mind, however, that no pediatrician will tell you whether a child is "right for you" or whether you should "accept the referral." Pediatricians who perform pre-adoption consultations want to help you make an informed decision. And they might talk about some aspects of adoption that are difficult to hear — for example, the risks of early childhood trauma and how much a birth mother's prenatal history may affect a child's life. Again, these physicians are sharing their professional opinions based on their own experiences. You don't have to agree with what the physician says, but do take note. Feel free to ask lots and lots of questions and to ask for further clarification if you don't understand an answer.
Any pediatrician who assists families during the pre-adoption period might offer a range of different services and will understand the importance of being available quickly. Some offer a onetime medical record review. Others will maintain ongoing contact during the pre-adoption period and will continue to answer your questions. If you are traveling, some will help you prepare as you get ready, and some will also provide the option for you to contact them during your trip. You will want to ask your physician about response time and to clarify with your physician expectations about what services are included and for what length of time. Most, but not all, pediatricians charge a fee for their adoption consultations. Some pediatricians who perform pre-adoption consultations also perform the recommended comprehensive post-adoption evaluation (see Chapter 3). And some of these physicians will provide ongoing primary care for your child.
Even if you have adopted before or you are an experienced parent, I recommend you establish a relationship with a pediatrician who is familiar with adoption.
What Parents Ask Me About Adoption
I always tell all parents — whether they've adopted or not — that there are no "stupid" questions. If you don't know something and you want an answer, just ask. You are doing your job as a parent. Some parents have no idea what to ask during these pre-adoption consultations, and that's OK. Even a question such as "How much should I feed her the first day?" is a great question. Here are my answers to pre-adoption questions that I'm often asked.
She looks so healthy in the picture. Is she going to be OK?
"Is my child going to be OK?" is the crucial question. I wish I could always tell parents that their child is going to be healthy. The reality is that no one can offer that type of reassurance. For all the reasons you'll read about later in this book, it is impossible to guarantee — or know — that any child is going to be healthy, even if the child's medical records indicate that that might be the case. When a child develops a medical condition or a mental health concern, pediatricians often don't know the reason. Adopted children are at greater risk of certain conditions that can affect a child's overall health, which we discuss in later chapters. Our job, as pediatricians, is to provide the support and education to ensure that every child receives appropriate medical care.
Do you recommend we meet our child's birth mother?
If you have an opportunity to have an open adoption, I would recommend you do. An open adoption establishes a foundation of honesty about everyone's life circumstances. It reduces the association of shame and guilt that used to be so much a part of what adoption meant. These days, most people are highly supportive of open adoptions. Your child will want — and need — to know about her birth family, and her birth family may want to know about her as well. While circumstances at some future point might make regular contact difficult, meeting your child's birth mother (and father) and finding out as much as you can now will be very helpful in the long run.
I'm adopting from foster care. Can I talk with you about the preplacement visits?
Yes, you can ask questions about anything that comes up during preplacement visits. Your physician may also have some questions for you about what you have observed. Preplacement visits are a wonderful way to help you and your child establish some continuity and will help as she transitions from a foster home to your home.
What should I bring on the trip?
Nowadays, it often doesn't matter whether you are traveling to the next state or around the world to adopt. You can usually get what you need right where you are. But since I believe in my "be prepared" motto, here are several items that I recommend you always have handy.
Food
Food is critical! Depending on how old your child is, you may have to prepare baby formula, so always have some extra with you. You do not need to use boiled water, but you do need to use bottled water if you are out of the country. You will also want to have some type of nonperishable healthy snacks, if your child is older than 9 to 12 months. A hungry child is an unhappy child.
Medical supplies
You won't need a lot of medical supplies, but I suggest bringing some type of fever-reducing medication and medication to treat an allergic reaction. Your pediatrician can give you an estimation of how much medication to give, based on your child's weight. (Note that if your child is a newborn and has a fever, you will need to take your child to an emergency department for evaluation.) If your child is vomiting or has diarrhea, you may need to use a rehydrating solution, so bring some along. You can mix the packets of rehydrating solution with bottled water. You will also want to have some type of over-the-counter antibacterial ointment to treat minor skin infections. And remember to bring any medications you take.
I generally recommend that you do not need to bring antibiotics. If your child becomes sick enough to require antibiotics, I would recommend that you take her to a local physician or hospital. You can also reach out to your pediatrician for advice. Robin remembers calling her adoption medical specialist, who, several time zones away, pulled over to the side of the road to take her call.
Clothing
Sometimes it's hard to know exactly how big your child will be, so I suggest taking a few sets of clothes in different sizes. If you are a new parent, bring clothing that is super simple to put on and take off. Dressing a toddler can sometimes feel like a wrestling match! Also, pay attention to the type of clothing your child is wearing when you meet her. Is she in layers or dressed lightly? Are her clothes tight or loose fitting? You will want to keep her dressed as much the same as possible to help the transition.
Diapers
Parents often wonder whether they should bring diapers for an older child. Even if your child's medical records state that your child is toilet-trained, I would still pack some diapers or training pants (eg, Pull-Ups). Many children are accustomed to sitting on a potty every 2 hours, so the assumption is often made that they are toilet-trained. When the routine changes during the transition, your child may start to have accidents. What might be going on? Perhaps your child has never really been toilet-trained, so she hasn't developed the "bladder talking to brain" mechanism. Or, she doesn't know yet how to signal or communicate to you that she needs to use the bathroom. In addition, many children regress and resort to pre-potty behavior when their lives get turned upside down. If your child starts having accidents, please support her. She's confused, not misbehaving. Put a diaper or Pull-Up on her. You will all be happier, and you can work on toileting skills when you are home.
Toys
Parents almost always ask me how many and what type of toys they should bring. If you are adopting a newborn, toys aren't really necessary. Your newborn will do what all newborns do — namely, eat, sleep, and poop! You will stimulate her by making great eye contact, talking, singing, and swaddling. If you are adopting an older child, she may or may not have had exposure to toys, and it is highly unlikely that she will have had an overwhelming amount of play items. So, if you pack toys my advice is (1) the simpler, the better and (2) the fewer, the better. Try to find 2 or 3 toys that stimulate different types of senses — for example, visual, auditory, and touch. Bring a stuffed animal or blanket. I'm also a fan of age-appropriate books, especially board books. But don't be too surprised if your child has never seen a book. Try to read to her, but know she may reject that idea since it's a new activity. Also, don't be alarmed if your child has no clue how to play with her toys or stuffed animal. You can teach her and model caregiving and cuddling behaviors.
How will my new son/daughter react to me?
"How will my new son/daughter react to me?" is another difficult question to answer. Even if I could predict your child's initial response, most likely her response to you will change over time. Remember that most children, even older children, can't really process what's happening. Some children are very excited initially and may jump into your lap and put their hands in your face, pull your earrings, or tug at your beard. Others may refuse to make eye contact and may shy away from you. Some children won't stop crying. Babies may be fairly easy to console, but not always, and without language, it can be really challenging to understand why any child is upset.
No matter how your child reacts, my advice is to stay calm and take the cues from your child. Don't insert yourself too quickly into a situation. Try to think about what it's like to be your child and what might be going on for her. Use a soft, reassuring voice and get on the same level as your child, which might mean sitting on the floor. Sometimes, being there for your child is all she needs.
Depending on your child's age and developmental level, try to find something that might interest her. But don't offer a lot of toys or options quickly. Doing so might further disorient her. Instead, give her time to relax. She will respond eventually, but doing so may take a few minutes, a few hours, or even a few days. I promise that you will connect with your child. I just can't promise when.
How will I feel?
All I can tell you is that the experience of adoption will feel a bit surreal. Robin and I both felt this way — all the preparation and the waiting and the expectations and the feelings converged at once. You may find yourself filled with joy and terrified. You may witness your child's birth, which can be a very frightening experience if you've never seen a child being born, or it may seem like the most beautiful thing in the world. You may feel as if you've made a mistake, you have no business being a parent, and you don't know what you're doing. All these reactions are within the expected range of emotions. When you feel overwhelmed, notice the feeling and acknowledge it. If you can share it with someone, that will help too.
What to Do Before Your Child Comes Home
Check your own health
It's a good idea to see your own physician to make sure you are in good health! If you are traveling internationally, check in with your physician or go to a travel clinic, as you may need immunizations to protect you from diseases endemic to the country you're traveling to.
If it's flu season, get a flu vaccine, regardless of whether you're traveling. Even if you don't typically get a flu vaccine, you are now a parent, and your child is more susceptible to the flu than you are. If your child gets sick, there's a good chance that you are going to get sick as well. If you are sick, you can't take good care of your child.
Get into shape
Before your child comes home may be the last time you really get to focus on your physical well-being. Being a parent is exhausting, both physically and emotionally. If you are not in great shape and are not used to moving, holding, or carrying children, your body will ache right away. If you are adopting a young child or an infant, I suggest purchasing a baby carrier of some sort and putting a 15-lb bag of cat litter in it and wearing it in your home. If you've been meaning to learn yoga or start swimming, do it! You will feel better and can try to continue these practices after your child arrives. What an excellent way to role model a healthy lifestyle for your child.
Set up your child's room
Since most parents have already thought of how they want to set up their child's room, I like to remind parents to think about the environment that their child has been sleeping and living in, and I like to suggest that they try to duplicate this environment as best they can. Doing so does not mean filling a child's room with dozens of toys and games or having brightly colored walls, bedding, and furniture. Keep your setup simple. If your child lived in a foster home with 3 other children and shared bunk beds in a small bedroom, she may be extremely unhappy alone in a queen-sized bed. If your child slept in an orphanage, it was probably pretty noisy with the sounds of crying children. Being in a quiet, dark room may be very scary. You might have to make some changes after you come home. See how your child reacts to her room, and make any necessary adjustments. Being flexible is an essential parenting skill.
Knock a few items off your bucket list
Before your child comes home may be the last time you have some adult freedom for a while. Travel to that place you always wanted to visit. Check in with your former roommate from college. Read that novel that's been waiting for you. Go skydiving. Take the cooking class. Be kind to yourself.
Meeting Your Child for the First Time
The van pulled up to the hotel, and the door opened. There she was! Sara looked so much smaller than we'd imagined. Her caregiver brought her inside. The minute she set her down, Sara started to cry — and she cried the rest of the day. We couldn't do anything to console her. She hated being held. She refused to eat or nap. She didn't seem interested in any of the toys we brought along. We were distraught. This was not how we thought meeting her would go.
— Dave and Janet, meeting their 10-month-old daughter for the first time
What to expect the day of
The day has arrived. Maybe you're going to be in the delivery room, or maybe you're going to be halfway around the world. Maybe it's the day your foster child officially becomes your adopted child. Maybe you've been waiting for years for this day to come, or maybe it's happened much faster than you anticipated. Whatever the circumstances, you are adding a new member to your family. Congratulations! You will remember this day forever, and you will tell your son or daughter this story over and over.
I know that most parents feel pretty nervous. They don't sleep well the night before. They misplace their car keys, they don't know when they last ate, or they forget to bring something with them that they need. I let them know that these reactions are typical and expected. Who would sleep well the night before their family composition changes forever? Neither Robin, nor I, nor our spouses, did.
(Continues…)
Excerpted from "Caring for Your Adopted Child"
by .
Copyright © 2019 Elaine E. Schulte, MD, MPH, FAAP, and Robin L. Michaelson.
Excerpted by permission of American Academy of Pediatrics.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.
Table of Contents
Foreword xiii
Please Note xv
Acknowledgments xvii
Introduction xxi
Chapter 1 Getting Ready to Bring Your Child Home 1
Chapter 2 A New Everything! Welcoming Your Child Home 17
Chapter 3 Your Child's First Pediatric Visit: A Comprehensive Health Evaluation 37
Chapter 4 Your Follow-up Visit: How Are Things Going? 59
Chapter 5 Health Issues and Conditions 83
Chapter 6 Attachment: The Foundation of Connections 101
Chapter 7 Your Child's Emotional Health: What to Watch for and When to Worry 123
Chapter 8 Learning and Attention Challenges 143
Chapter 9 Talking About Adoption 169
Epilogue 191
Resources and References 195
Index 203