When your foster or kinship newborn has known prenatal exposure to opioids, Methadone, Suboxone, or other substances, it’s common to feel overwhelmed with worry for the baby’s prognosis. It’s also common to be anxious about creating attachment when the baby is in the throes of withdrawal. If you can be present during the baby’s withdrawal period, knowing how to comfort her can help create bonds of attachment between you.
We understand that you won’t always know what will happen at the hospital in many foster/kinship situations. But if you can, check with your agency and the hospital for a clear understanding of their policies. Be prepared that protocols might vary widely regarding the participation of foster parents and kinship caregivers in the care of newborns who are withdrawing from prenatal substance exposure. Of course, in the case of a planned foster or kinship placement, you may have the opportunity to make an in-hospital plan with the expectant mother to ensure the baby’s best interests.
Setting A Sure Foundation
Once you are at the hospital, actively participating in your foster or kinship baby’s care, these tips will help you build attachment and establish yourself as a haven for this sweet new baby.
We know this is easier said than done in a busy hospital unit with beeping monitors and staff frequently checking in on the baby. Consider working out a plan with the nursing staff on the NICU or Labor and Delivery/Post-Delivery unit to do “cluster care.” Clustering the baby’s care allows the medical staff to monitor the baby in short visits several times a day, instead of nursing or medical staff coming in and out at all hours of the day or night.
Another way to reduce stimulation is to create a gentler ambiance in the room. Turn off overhead lights. Silence the monitors when you can. Use soft blankets from home. Consider quiet instrumental music, white noise, or other soothing background noise.
Because hospitals are now quite educated about the benefits of caregiver participation, many will accommodate rooming-in with a foster or kinship baby during withdrawal. Be sure to pack for a potential hospital stay of up to a couple of weeks. Bring comfy clothes that are soft for the baby’s potentially sensitive skin, soft blankets for snuggling, and your favorite pillow.
Ask the hospital in advance about the availability of meal ordering, cafeteria hours, shower facilities, and parent-resource rooms. If this is your first long-term stay at a hospital, ask an experienced adoptive, foster, or special needs parent for other tips for extended hospital stays. They can be an excellent resource for you in the coming months as well!
Babies who are struggling with the sensitivities and pain of withdrawal will gain therapeutic benefit from your skin on theirs. It’s a regulating effect for their body systems and yours.
Choose clothing that will easily facilitate the baby laying on your bare chest. Think about baby-wearing if you can walk around the neonatal unit with him. You might have to start with short periods of this close contact – for you and the baby to adjust.
Give yourselves time and grace to ease into it if skin-to-skin feels unexpectedly too intimate or otherwise uncomfortable. When a placement is unexpected or moves very quickly, as many foster/kinship care situations do, you might need some time to process all of it. And that is okay! If your spouse or partner is with you, take turns with the baby to give yourselves a break. It’s also an equal opportunity for each to bond with the baby.
Awareness of baby’s responses.
When a newborn is in withdrawal, he might be experiencing hypersensitivity to stimulation around him. Be aware of and responsive to your foster or kinship baby’s over and under-sensitivities. His sensory system is struggling to regulate. During withdrawal, it’s better to err on the side of lower stimulation from lights, voices, physical contact, monitors, and other typical hospital stimuli. Think “less is more” for a baby that is working through withdrawal.
Swaddle and rock.
There will be nurses available to teach you the various swaddling and rocking techniques they have found most effective for newborns who are in withdrawal. Practice a few and see what works for this baby. Be patient – not only are you new to this, but the baby is also. Take some time to work with the parent educators or nursing staff to figure out what works.
Ask about the Eat Sleep Console model.
Many hospitals around the country are educating their staff on a new rating scale called the Eat Sleep Console model. The medical team measures how well the baby is eating, sleeping, and allowing or responding to soothing by the caregivers. As more foster/kinship caregivers participate in care during a baby’s withdrawal process, the medical team and caregivers are learning how to communicate and assess the baby’s progress collaboratively.
One of the benefits of this rating scale includes earlier release from the hospital to home care, so it’s worth educating yourself and talking with the newborn’s team about it.
Continue Building on This Foundation
Once your foster or kinship newborn is released to go home with you, make every effort to continue to build upon the foundations of attachment that you began in the hospital. For many foster and kinship caregivers, it will feel like a long season of hands-on care, and that can be exhausting. You won’t have the nursing staff available to watch the baby while you shower or step away for a break. You might not ever finish a hot cup of coffee in those early days home!
Rally your “village” to help you.
Consider how you can set yourself up for a smoother transition home while adjusting to the addition to your family. Some of the best things you can do for yourself and your foster or kinship baby are those tasks that you let others do for you, like:
- Laundry, cleaning, and grocery shopping help
- Meal trains or gift card for meal delivery
- Childcare for the other kids already in the home
- Mom-taxi duties or carpool help
- Playdates, homework help, and occupying “gifts” for the kids already in the home
Get the word out.
As soon as you know you and your foster/kinship baby are coming home, it might be helpful to share the news with your closest support network. It might also be wise to set some expectations at that same time. It’s not uncommon for closest family supporters to want to be there to welcome you home. Folks want to celebrate your new arrival and might be tempted to just “pop-in” with a gift for you or the baby. However, as we’ve noted, “extra” stimuli can put you and your baby off-track significantly while transitioning from hospital to home life.
Gently but firmly find a way to let folks know what your needs are right now. Assure them that you’ll give them all the heads up when you are ready to dip your toes back into your social life.
What do Kinship Caregivers Need to Succeed? ~ an AdoptionEd.org course
Don’t Neglect Yourself
While you are in the hospital with your new foster or kinship baby, be kind to yourself. Figure out what self-care works for you during your stay. And when you come home to your regular life, be sure to prioritize your needs as well. It’s challenging to be patient and gentle with a fussy, unsettled baby if you are sleep-deprived, hangry, or feeling stressed and overwhelmed.
Self-care is vital to building an attachment with your foster/kinship baby going through withdrawal, just as the in-hospital tips are vital to the baby’s well-being.
Image Credits: bradleyolin; The Hudson Family; Sean Freese