Reflecting on my journey as a foster parent, I've come to realize a profound truth: you cannot out-love or out-nurture a baby exposed prenatally to substances. Despite my best efforts and deepest wishes, the reality has been a challenging awakening.

Baby girl being bathed
Baby girl being bathed

In my years of fostering, I've cradled infants battling the harrowing effects of withdrawal. I've walked countless miles across creaky floors at night, soothing cries that pierced the quiet darkness. I've cleaned up after spit-up more times than I can count, tended to severe diaper rashes, and calmed endless bouts of irritability and sneezing. Each time, I held a firm belief that my love and care could mitigate their early suffering—that as these little bodies purged the toxin of drugs and alcohol, my nurturing would fill the void and set things right.

Initially, I was driven by a naive hope that once the substances were out of their systems, the children would be fine—that nurture could triumph over nature. But this was not the case.

The heart of the issue is that prenatal substance exposure can profoundly disrupt the natural development process, leading to permanent neurological impairments. These challenges can persist into adolescence and adulthood, shaping their social behaviors and interactions. As my foster children grew, I began to see the lasting impacts of their early exposure—struggles that didn't just fade as they got older but instead evolved into new challenges.

Baby girl sleeping in hospital bed
Baby girl sleeping in hospital bed

Understanding that I couldn't out-love or out-nurture such deep-seated issues, I realized I had to adapt my parenting. It wasn't about striving harder; it was about shifting my approach to meet the unique needs of each child.

This insight led me to a path of parenting that is as unique as the children I care for. It involves recognizing that the withdrawal symptoms are just the beginning of a lifelong journey. It involves setting expectations that align with their capabilities, not just where I hoped they would be.

To anyone loving or working with children from “hard places,” know this: believing that time or traditional parenting strategies alone can address the impacts of in-utero exposure is a disservice to these children. We need to become well-informed about the prevalence of prenatal substance exposure in the foster care and adoption systems. We must be vigilant in observing behaviors indicative of such exposure and proactive in seeking early diagnoses.

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Parenting Techniques

My approach to parenting has become unapologetically tailored. I don't expect others to understand fully, but it's what my child needs. It's not what typical parenting might look like, but it is necessary.

Here are some ways I've adjusted my parenting techniques:

  1. Parenting the Emotional Age: I focus on their emotional and developmental age, which often lags behind their chronological age. This might mean treating a ten-year-old like a five-year-old based on their emotional responses and needs.
  2. Simplifying Communication: I've learned to speak slowly, using simpler words and repeating the same phrases to reinforce connections between words and actions.
  3. Managing Inconsistency: I accept that just because my child could perform a task yesterday doesn't mean they can do it today. Their brain doesn't always access information consistently.
  4. Repetition as a Teaching Tool: I may need to teach the same concept a hundred times before it sticks. I don't punish forgetfulness; understanding that memory issues may be a lifelong struggle is crucial.
  5. Supporting Their Executive Functioning: Since my children often struggle with cause and effect, working memory, and executive functioning, I act as their external “thinking brain,” helping them navigate daily tasks and decisions.
  6. Distinguishing Can't from Won't: Recognizing when they truly can't do something as opposed to when they won't allows me to step in with the right support rather than discipline.

While I cannot out-love or out-nurture the effects of prenatal exposure, I can forge a compassionate path that respects both their challenges and their potential.

Raising children with prenatal substance exposure presents unique challenges, but fortunately, there are a variety of resources available to support foster parents in this critical role. Understanding and accessing these resources can make a significant difference in the lives of both the children and the caregivers.

Baby Lying Down on Hospital Bed Getting a Check-up
Baby in hospital bed

Resources for Foster Parents

Training Programs: Many foster care agencies offer specialized training programs that address the specific needs of children with prenatal substance exposure. These programs typically cover topics such as understanding the medical and developmental issues these children may face, effective behavioral management strategies, and navigating the healthcare system to ensure the child receives the necessary interventions.

Creating a Family offers comprehensive workshops for foster, adoptive, and kinship parents. These workshops include evidence-based, trauma-informed content to help parents recognize signs of prenatal exposure, understand the diagnosis process, and learn effective parenting strategies. More details and registration can be found on the Creating a Family website (Creating a Family).

Support Groups: Support groups are invaluable for foster parents. They provide a platform to share experiences, seek advice, and gain emotional support from peers who understand the unique challenges. These groups can be found through local foster care agencies, churches, community centers, and online platforms. Organizations like the National Foster Parent Association (NFPA) often have links to local support groups.

Creating a Family also provides support groups and a variety of free online courses for foster parents. These resources help caregivers connect with others facing similar challenges and learn from their experiences (Creating a Family Education).

Medical and Therapeutic Resources: Foster parents can access pediatricians, neurologists, and developmental specialists who understand prenatal substance exposure. Occupational, physical, and speech therapy can be crucial in addressing developmental delays. Mental health support from psychologists or counselors who specialize in early childhood trauma and exposure-related issues is also critical.

Hope RISING Clinic for Prenatal Substance Exposure offers specialized therapy and family support services. They provide evaluations, diagnosis, and evidence-based interventions for children up to age 13, focusing on a trauma-informed and neurobehavioral approach to care. They also support the entire family with coaching and mental health counseling (Hope RISING Clinic).

Educational Resources and Advocacy: Understanding these children's educational rights and special needs is crucial. Resources such as the Individuals with Disabilities Education Act (IDEA) provide guidelines and support for accessing special education services. Advocacy groups can help parents navigate these rights and obtain necessary services.

Baby in Hospital
Baby in Hospital

How Society Can Support These Children and Families

Increased Awareness and Education: Society benefits from increased awareness about the challenges and needs of children exposed to substances in utero. Educational campaigns can help destigmatize their conditions and promote a more compassionate understanding of their behaviors and needs.

Policy and Funding: Advocating for better policies and increased funding for foster care systems can help ensure these children and their caregivers receive adequate support. This includes funding for specialized training, healthcare, and educational resources.

Community Support Programs: Community-based programs can provide additional resources such as respite care, which allows foster parents to take necessary breaks. Community centers and nonprofits can offer recreational programs tailored to children with special needs, providing safe and supportive environments for development.

Volunteer Programs: Encouraging community members to volunteer in programs related to foster care can provide additional support and resources. Volunteers can offer tutoring, mentoring, and assistance with daily caregiving tasks, reducing the burden on foster parents.

Corporate and Employer Support: Businesses can play a role by providing flexible work policies for foster parents, such as flexible hours and the possibility of remote work. Corporate sponsorship of child welfare programs can also provide critical funding and support for specialized services.

While the challenges of raising children with prenatal substance exposure are significant, a combination of specialized training, support groups, medical and therapeutic interventions, and broad societal support can create a network of care that significantly improves the outcomes for these children and their families. We must commit to understanding and actively supporting these efforts to nurture and advocate for some of our most vulnerable children.

This journey starts with me and everyone who chooses to stand in the gap for these precious lives.

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