Each year in the United States, as many as 200,000 babies and children go into foster care. More than half are younger than 5 years old, and more than 20% are babies who haven’t yet reached their first birthday.
Infants and young children in foster care face high risks for developmental, emotional, behavioral and health challenges. With the right support, however, foster care can be a powerful opportunity to help children heal and thrive.
Why do children enter foster care?
Children enter foster care when their home life is unsafe or unstable. Many have experienced abuse or neglect because something makes it impossible for their parents to care for them properly. Alcohol or drug use, serious psychiatric or mental illness and separation through death, prison or abandonment are all common causes.
Children entering foster care are more likely to have experienced events and sitations that disrupt these foundations for healthy development. Examples include:
Why early support & intervention matters
Without enough early support and intervention, adverse childhood experiences such as these can change brain architecture and alter a child's development. This can contribute to long-term challenges such as:
How does foster care help children?
Foster care offers children a safe, stable and nurturing environment. It provides children with immediate protection, moving them from unsafe places into homes with foster parents who agree to provide food, shelter, health care, education and emotional support.
Foster care placement not only protects children from immediate harm, but also provides a chance to identify early developmental delays and offer support to improve their growth and development.
What health threats do foster kids face?
Children who enter foster care are more likely than their peers to face serious concerns that affect their brains and bodies in negative ways. Some examples:
Prenatal health risks
Some foster kids are born to parents who use drugs, tobacco or alcohol. This can create health risks such as fetal alcohol spectrum disorder, which affects the brain, growth and appearance of children. In severe cases, infants are born addicted to the drugs that pregnant parents used and need special post-natal care to survive.
Financial struggles
Foster children may come from low-income families without access to proper health care. They may not benefit from the medical attention that healthy babies and children get early in life—everything from well-child care visits to vaccines and more.
Racism or cultural hatred
Racism and unfair treatment can harm a child’s physical and emotional health and development. They can also make it harder for families to get the support they need.
Kids from Black, Brown, Native American and Alaskan Native families are over-represented in foster care. This reflects
unfair patterns in the system that need to change, such as in child welfare reporting, removal decisions, reunification and
permanency planning. Helping families stay safely together is important. Support like financial help, care by relatives (
kinship care) and community-based prevention services can help families at risk for foster care placement and improve outcomes for children.
Developmental delays
Studies show that foster care kids have trouble reaching growth and school milestones. For example, they may walk or talk later than other children. Children in foster care are at especially high risk for developmental delays. Although many children in foster care need developmental support and qualify for developmental services, only 10–26% receive them.
How shifts in health providers can complicate risks
Babies and young children in foster care may have missed early checkups meant to uncover and treat health issues. Some may not have seen a pediatrician at all before entering foster care. Kids who have been to the doctor will need to see a new doctor when they move to foster homes. But in the transition, key facts about their health may get lost.
Health risks that often go unreported
Young children may enter the foster care system without much information on their birth family’s health history. So, for example, their new pediatrician might not know that parents and other family members lived with conditions such as diabetes, heart disease, cancer, asthma, obesity, blood diseases like sickle-cell anemia or mental health issues.
These conditions can run in families. Health screenings can help uncover signs that a child may also be at risk. Foster care placement is an opportunity to gather and add a child’s medical history to their electronical medical record so they can receive appropriate, ongoing care in the future.
How AAP policies support the health of all foster kids
The AAP is devoted to the health and well-being of every child, from birth to adulthood. Our latest policies call for special attention to the health of children in foster care, especially babies and young children. We base these policies on science that shows what all children—and especially foster kids—need to grow and thrive.
Key points that guide our recommendations:
- Foster care placement gives everyone a chance to pause, look closely at a child’s health and development, and make sure they get the support they need.
- Children in foster care should automatically qualify for special health services and early intervention services that help them develop to their full potential.
- The medical consent form signed by guardians on entry into foster care should extend to developmental intervention services. These should be considered standard medical care, just as important as care for a child’s asthma or growth delays.
- Pediatricians and family doctors can play a key role in screening for developmental issues, trauma exposure and prenatal risks that can harm a child’s health. Working with foster parents, they can plan a course of care that will help children recover and thrive.
- Parents and pediatricians can work together to reduce the impact of early stress and neglect so children can heal and grow.
- With coordinated care and supportive early experiences, children in foster care can thrive and reach their full developmental potential.
Resources for foster parents
Adults who give time and resources to care for foster children deserve thanks and respect. They give kids who otherwise might fall through the cracks the chance to grow into healthy, productive adults. If you are a foster parent, or considering becoming one, you may benefit from these resources: