Foster Families Needed for "Substance-Exposed" Infants....

...born in Illinois coupled with the overcrowding of the Columbus/Maryville Reception Center grabbed newspaper headlines and the hearts of the public during 1992. From January to March 1993 [the Foster Parent/Advocate Newsletter of Chicago] ran a series on "Fostering the Drug-Exposed Child," encouraging foster parents to jump in and foster drug-exposed children by giving information and offering informational meetings and a tour of the baby unit at the Columbus/Maryville Reception Center.

Short-term residential resources were developed and multiplied as the "answer" to the volume of drug-exposed children. Foster parents protested. The informational meetings for foster/adoptive families ended. Public interest waned. The media story died. The infants kept coming, but leveled to a consistent 3,500 substance-exposed babies being born annually in Illinois.

Foster homes are again needed to get the renamed "substance-exposed" babies out of institutions.

Welcome back to the future! Study on "medically involved" children completed

With a new DCFS [Department of Children and Family Services] administrator and a new DCFS Medical Director, pediatrician Dr. Paula Jaudes moved quickly after their appointments to study the entire area of "medically involved" children in foster care. An advisory committee was formed, which included key personnel from the guardian, special services, clinical services, interagency division, and interagency management.

A detailed analysis of the medical needs of children in foster care, internally released in April 1995, indicated that approximately 10% of all Illinois foster children met the committee’s definition of "medically involved."

Where are the new drug-exposed infants now?

Diagnostic residential programs still house the majority of the babies coming into substitute care during the first year of their lives. Now known as "substance-exposed" infants, 25% of these babies live with relative foster parents.

Consider taking a baby!

Some good things have happened since the call to foster parents went out the last time—the new Healthworks system is now available for help and referral. More is known now about the long-term effects of drug-exposure on children and what works best to help them reach their potential. Agency programs are generally offering more support because they know what foster parents need to succeed. It’s a new day! Read the questions in the related article to help you negotiate the support you need from your agency. Consider bringing a baby into your heart and home!

Reprinted from the "Foster Parent Advocate Newsletter," June-July 1995, published by Fostering Illinois, Department of Children and Family Services, 100 W. Randolph - 4th floor, Chicago, IL 60601.

Issues in Fostering the Substance Exposed Infant
Questions to Ask Your Agency Before Placement

Is the infant on an apnea monitor? Treating physicians may put substance-exposed infant (SEI) babies on an apnea monitor, which measures the baby’s heart rate and breath rate (not life support), for 1 to 6 months, based on the medical needs and history of the child. There is no policy that requires the use of apnea monitors with SEI babies.

Foster parents are trained on the use of the apnea monitor by the company in about 20 minutes. The monitor company also provides 24-hour service. Monitors have battery packs, enabling babies to go on outings where electrical outlets are not available.

What medical problems are known? What are the results of the last physical examination?  The institution currently taking care of the baby has the information. Residential programs perform a thorough assessment and will train foster parents in the care and/or services needed by the specific baby. Foster parents should be prepared to be certified in infant CPR, in case of emergency. Classes in infant CPR are about 2 hours and may be offered or reimbursed through your agency.

Has the baby been tested for sexually transmitted diseases or for AIDS? If not, what are the future plans for testing? SEI babies should be screened for HIV at birth. Tests for the HIV virus may be done at the physician’s discretion—either the delivering physician, or the physician working for DCFS after the baby enters the system.  Mothers receiving prenatal care are routinely tested for syphilis during their prenatal exams. Many addicts do not get prenatal care, increasing the risk of sexually transmitted diseases, especially syphilis. Ask about testing!

What is the baby’s current behavior? Does he cry constantly? Sleep constantly? Go instantly from deep sleep to agitated crying? What are his developmental delays?  Much behavioral and anecdotal information should be available from the residential caregivers about each baby’s current behavioral traits. Asking questions and reading behavioral reports will show you how much difficulty the baby may have in bonding with you and adapting to his environment.

1. What behaviors can you and your family really handle?
2. What outside services are necessary or planned for the baby?
   Know what transportation and extra "running" will be required of you and your family.
   Every SEI infant should be assessed and then connected to Early Intervention Services to address developmental delays. Ask where these services are available in your neighborhood and if the connection can be made for you.
3. What specific support, referral and respite services are available to you through the agency to effectively care for this child?

Financial and other supports may vary significantly from agency to agency. Foster parents considering the SEI infant should carefully review both compensation and other supports with their agency in order to make an informed decision.

Reprinted from the "Foster Parent Advocate Newsletter," June-July 1995, published by Fostering Illinois, Department of Children and Family Services, 100 W. Randolph - 4th floor, Chicago, IL 60601.

Ways to comfort a drug withdrawing baby

1. Wrap or swaddle the baby in a soft blanket.
2. Keep the lights dim to decrease sensory stimulation.
3. Drape the crib with a blanket or sheet to decrease light and noise.
4. Keep the noise level low.
5. Play soft, soothing music.
6. Hold the baby frequently.
7. Use a pacifier.
8. Use unstarched, soft blankets, sheets, etc., to prevent rub marks.
9. Hold baby firmly.
10. Rock gently and slowly.
11. Speak softly and calmly.
12. Give gentle massage.
13. Avoid bouncing and rapid patting.
14. Place the baby on his/her stomach over a soft ball (beach ball type) to ease abdominal pain.
15. Use a front pack to carry baby (baby may want to be covered with blanket of large sweatshirt.
16. Make sure medication is given on time, at regular intervals.
17. Plan for respite care.
18. Stay calm.
19. Ask for help when you need it.

Some signs of overstimulation

• Avoiding eye contact
• Tension
• Sucking on hands, fingers
• Frowning or grimacing
• Yawning

Adapted from material by Ruth Stroemple in the "Medical Foster Parent Handbook" (unpublished) and Zero to One