CHAPTER 22

The Adopted Baby

Whether you’re bringing home a newborn from the local hospital or a nine-month-old from another continent, becoming an adoptive parent is every bit as joyous, life-changing, and nerve-racking as becoming a birth parent. Although chances are you’ve been waiting for this moment even longer than birth parents usually do, you may feel surprisingly unprepared now that it’s finally upon you. Along with the excitement and elation you’ll feel when you first hold your baby in your arms, you’ll probably feel a fair amount of trepidation and uncertainty. Just like birth parents do.

As adopting parents, this chapter is specifically for you. But so is most of the rest of this book. Your baby is like other babies—and you are like other fathers and other mothers.

What You May Be Concerned About

GETTING READY

“My friends who are pregnant are involved in all kinds of preparations—childbirth classes, looking over hospitals, choosing pediatricians. But I don’t know where to start in preparing for our daughter’s arrival.”

Instead of surprising parents (of all species) with their babies without benefit of notice, Mother Nature wisely designed “gestation.” This waiting period before birth (or hatching) was meant to give parents a chance to prepare for the arrival of their offspring. A chance for the mother bird to feather her nest, the expectant lioness to prepare her lair, and nowadays anyway, for the human mother and father to decorate a nursery, take classes, toss around names, make key decisions about breastfeeding, child care, and pediatricians, and generally prepare themselves emotionally, intellectually, and physically for becoming a family.

For the couple about to adopt a baby, the waiting period is not usually a predictable and manageable nine months, as it is for other expectant parents. For some, usually those who go the agency route, the entire process may take years, but the big day itself may arrive unexpectedly, not leaving enough time for reality to set in, much less for preparations to be made—not unlike being told you’re pregnant one day and delivering a baby the next. For others, usually those who adopt privately, definite arrangements may be made to adopt a particular baby far in advance of the infant’s due date, giving the adoptive parents-to-be the opportunity to go through prebaby preparations that are not dissimilar in many ways to those of biological expectant parents. But no matter how much or how little time you have between learning you are going to become a parent and the actual arrival of that bundle of joy, there are some steps you can take to make the transition smoother:

Shop ahead. Read chapter 2 of this book. Most of the preparations for the arrival of a baby are the same whether you’re adopting or birthing. If you are uncertain as to the date, scout around for the crib, carriage, layette, and so on in advance. Have everything picked out (brand names, style numbers, sizes) and listed along with the store names and telephone numbers, so that you can call for delivery the moment you hear from the adoption agency or attorney. (Check in advance with the stores to be sure that your choices will be in stock.) If you are going the private adoption route and have an approximate arrival date, many stores will allow you to put your order in and then will hold delivery until you call. Such advance purchasing is a lot better than trying to do the shopping after the baby arrives, when you’re busy trying to get acquainted and adjusted.

Find out how adoptive parents feel. Talk to other couples you know who have adopted infants (or find adoptive parents on-line) about their concerns, their problems, and their solutions. Find a support group for adoptive parents and attend a few sessions—your clergyman, pediatrician, attorney, or adoption agency may be able to direct you in locating individuals or groups. Again, you may be able to find some of this support—as well as plenty of other resources—on the Internet. Or look to books for information and strategies.

Find out how newborns feel. Read up on childbirth so that you have some idea of what your baby has gone through when he or she finally does arrive. You’ll learn that after a long, hard struggle to be born, babies may be tired—something that birth parents understand because they are tired, too. Adoptive parents, usually exhilarated and excited rather than exhausted by their baby’s arrival, might be tempted to overstimulate the newborn rather than allow her needed rest. If you’re adopting an older baby, read up on the months that are already behind her, as well as those that are just ahead, keeping in mind that your baby may have some catching up to do developmentally if she has spent her first months in an orphanage or in an unnurturing home environment.

Learn the tricks of the trade. Take a parenting class that gives instruction in basics such as bathing, diapering, feeding, and carrying baby. Or plan on hiring a baby nurse or doula who is as good at teaching baby care as she is at practicing it, for a day or two, or longer if you prefer, to help out with the basics (see page 16). But be sure whoever you hire will help rather than intimidate.

Take a good look at babies. Visit friends or acquaintances with young babies, or stop in at a hospital nursery at visiting time, so that a newborn won’t seem so unfamiliar to you. Read about newborn characteristics in chapter 4. If you’re adopting an older baby, pay visits to those who are about the same age as your baby.

Pick your pediatrician. It’s as important for you to have your pediatrician selected in advance as it is for the expectant couple (see page 29). And don’t wait until you have your babe-in-arms to pay a visit to the doctor. A pre-baby consultation will give you a chance to ask questions and voice any concerns you may have about adopting a baby or becoming a parent. You’ll need someone who will be able to check your baby out on the very first day he or she is with you. Because the newborn’s health is a special concern, you will want the pediatrician to be available almost at a moment’s notice to consult with doctors when the baby is born and to give you advice on the prognosis if there is a problem. If your baby will be coming from overseas, there may be other health issues to be aware of. You may want to choose or consult with a pediatrician who has had some experience with caring for foreign adoptive babies (see box above for more).

ADOPTION MEDICINE

More and more parents today are choosing to adopt babies born in foreign countries where health care practices are often lacking. Though most of the challenges these parents face are no different from those faced by parents who adopt or give birth in this country (a baby is a baby no matter where he or she is born), there may be some concerns or questions unique to foreign adoption to which a regular pediatrician may not have the answers. Some parents turn for these answers to one of the dozens of pediatricians who specialize in foreign adoption medicine. These doctors have extensive experience in the medical, emotional, developmental, and behavioral issues of children born abroad (especially in underdeveloped countries) and adopted by parents in the United States, and can offer preadoption counseling (including an assessment of potential health risks) based on existing medical records. Since those records are often incomplete or nonexistent, pediatricians who specialize in adoption medicine also offer postadoption care, which routinely screens for problems specific to the child’s country of origin.

While most adoptive parents do not need a consultation with an adoption medicine specialist, some—particularly those who have reason to be concerned about their new baby’s health—will find the service useful. (You can find a directory of adoption doctors at www.aap.org/sections/adoption.) If you feel you might benefit from such a consultation, but don’t have an adoption medicine specialist in your area, your pediatrician may be able to confer with one and get responses to your specific concerns.

Consider breastfeeding. Some adoptive mothers are able to breastfeed their babies, at least partially. If you’re interested, check with your gynecologist to discuss the possibility, and see page 656.

NOT FEELING LIKE A PARENT

“Not having gone through pregnancy, I don’t feel much like a parent to our son, even when I hold him.”

You don’t have to be an adoptive parent to have trouble feeling like a “real” parent. Most birth parents experience the very same self-doubts as they hold their newborns, who often seem like strangers at first. After all, though the technical part of becoming a parent takes no more than giving birth or signing the final adoption papers, the emotional part takes a lot more. Bonding with a baby, whether a birth baby or an adopted one, is a process that occurs not in moments but, rather, gradually over days, weeks, even months. Few parents “feel” like parents during those challenging early days and nights, yet virtually all eventually do—usually once they’ve mastered some of the basics of infant care and managed to get into a rhythm (you will!) with their new baby.

Keep in mind that while you may have a hard time accepting yourself as a parent, your baby will have no such difficulty. You—who love, shelter, and provide for all of his needs—are the real thing to him. And you’ll know that long before you hear his first “Mama” or “Dada.”

LOVING THE BABY

“I’ve heard that birth parents fall in love with their babies right in the delivery room. I’m afraid that because I didn’t carry and deliver this baby, I’m never going to be able to love her in the same way.”

That all parent-baby love affairs begin in the birthing room is yet another parenthood myth. In fact, your fears are actually shared by a large proportion of birth parents who are surprised and disappointed to find they are not overcome by a great swell of love when they first hold their babies. And neither you nor they have anything to be concerned about. The mother-baby or father-baby love doesn’t miraculously reach full bloom at first meeting (or even first few meetings)—it takes time and nurturing to grow.

This love apparently grows for adopting parents just as it does for birth parents. Studies show that adoptive families form good strong bonds, particularly when the child is adopted before the age of two. Adopted children are often more confident than nonadopted children, tend to view the world more positively, feel more in control of their lives, and see their parents as more nurturing than nonadopted children do—perhaps because being an adopted parent, unlike being a birth parent, always happens by choice.

BABY’S CRYING A LOT

“Our baby girl seems to cry a lot. Are we doing something wrong?”

There aren’t any healthy new babies who don’t cry, and many of them happen to cry a lot—it is, after all, their only way of communicating. But sometimes, crying is increased by overstimulation, or stimulation of the wrong kind. Many adoptive parents are so excited about the arrival of their new babies and so eager to show them off that they expose them to a steady stream of visitors. Just because you aren’t exhausted from delivery doesn’t mean your baby’s not. Give her a chance to rest. Slow down, handle her gently, speak to her quietly. After a couple of weeks in a calm atmosphere, you may find she’s crying less. If not, she may have colic, which is no reflection on you or your care, just a very common pattern of behavior in the first three months of life (see page 186 for more on colic; page 123 for help cracking the crying code.)

THE WAITING PERIOD

Don’t have enough to worry about now that you’re a new mother (or father)? Here’s something else many adoptive parents need to keep in mind: As soon as the waiting period is over (the time during which the birth mother can change her mind about the adoption—as long as thirty days or even more in some states), be sure to finalize the adoption in court. Some parents forget to do this in the excitement (and exhaustion) of the newborn period, and thus end up not having legal custody of their children, something that can lead to serious complications later.

POSTADOPTION BLUES

“If postpartum blues are supposed to be hormonal, how come I’ve been feeling depressed since we brought our son home?”

If the baby blues were triggered solely by hormones, adoptive parents wouldn’t suffer from them—yet many do. That’s because a wide range of factors play a role in the baby blues, and many of them have absolutely nothing to do with hormones.

For instance, whether you adopt or deliver, life as you knew it (from how you spend your days to how you spend your nights, from how you spend your money to how much money you have to spend) will never be the same, and that takes some getting used to. Until you adjust to life with a baby (that is, life without much sleep or much romance, life without free time, life—if you’re taking maternity leave—without a career and possibly without a salary), you’re bound to feel a little unsettled, a little overwhelmed, and a little depressed. Also contributing to the baby blues for many parents (biological and adoptive, mothers and fathers) is the crumbling of confidence—that “all thumbs, no instincts” feeling—experienced almost universally by first-timers.

Since it is likely that at least some of the causes of your mood slump are the same as for traditional postpartum blues, many of the cures may help you, too. The tips throughout chapter 23 can help you shake the blues and let you enjoy your new role more.

BREASTFEEDING AN ADOPTED BABY

“After years of trying to conceive, we are making our family by adopting. I’m excited about that, but I’m very disappointed that I won’t be able to nurse when our baby arrives.”

Once a baby’s born, there’s just about nothing that a biological mother can do that an adoptive mother can’t. In this age of medical miracles, that even goes, to a certain extent, for breastfeeding. Though most mothers of infants who were adopted will never lactate enough to feed their babies exclusively from the breast, a few moms do manage to breastfeed their babies at least partially. Among those adoptive mothers who attempt to induce lactation, even those who fail to produce milk can reap the benefits of the special intimacy nursing builds in.

Breastfeeding will be possible only if the baby you are adopting is a newborn, not yet used to sucking on an artificial nipple, and if you have no medical condition (such as a history of breast surgery) that might prevent you from producing milk.

Before you decide whether Breastfeeding your adopted baby is right for you, ask yourself these questions:

Why are you so eager to breastfeed? If you simply want to give your baby the best nutritional start possible and to share the emotional pleasures of nursing with your new arrival, by all means go ahead and give it all you’ve got. On the other hand, if you’re trying to prove your worth as a mother or deny to yourself or to others (consciously or subconsciously), that your baby was adopted, you should reconsider. It’s important for you to come to terms with—and feel blessed about—the fact that your baby was adopted; if you don’t, you and baby may run into problems later.

How committed are you? Are you willing to put everything else in your life on hold while you try to get lactation going? You may have to nurse almost constantly and face weeks of intense effort and possible frustration, with no results. Are you ready to accept the idea that you may not succeed, and that if you do, you may be able to supply only part of your baby’s nourishment?

Will you have support? Ask your spouse and other family members whether they’ll be behind you all the way. Without that support, you’re much less likely to succeed.

If you’re determined to do whatever it takes to try breastfeeding your baby, following these steps will increase your chances of success:

Image Visit the doctor. See your gynecologist to discuss your plan and to be sure that no condition exists that will make breastfeeding impossible or especially difficult in your case. Ask for advice on logistics, too. If he or she is unfamiliar with lactation induction, ask for a referral to a doctor who is familiar with it—possibly a pediatrician.

Image Read up. Chapter 3 will tell you everything you need to know about breastfeeding.

Image Get help. Call the La Leche League in your community and ask them to recommend a lactation consultant who can join your support team.

Image Get a head start. If you know in advance approximately when your baby will be arriving, begin priming your breasts for that momentous day. About a month or so in advance, start stimulating lactation with a breast pump, preferably an electric one. If you successfully produce milk before your baby arrives, bag it and freeze it for future use. See page 155 for information about expressing milk.

Image Stimulate while you nurse. Order a supplemental nutrition system (SNS) to be delivered when your baby arrives. An SNS will allow your baby to stimulate milk by suckling while simultaneously being nourished by supplementary formula. Even if you aren’t able to get a head start on milk production (because baby arrives unexpectedly), an SNS will help you catch up, without compromising baby’s nutrition. And if you don’t end up making enough milk to completely satisfy baby, you can keep using the SNS as long as you breastfeed. See page 167 for more on SNS.

Image Encourage let-down. If you’re having trouble with milk let-down (that is, there’s milk in your breasts, but it needs hormonal help making its way out), ask your doctor about prescribing an oxytocin nasal spray and/or a medication such as chlorpromazine or theophylline. One of these may stimulate the pituitary to produce prolactin (a hormone essential in milk production), but none should be used for longer than a week or so.

Image Relax. Get plenty of rest, relaxation, and sleep. Even a woman who has just given birth can’t produce adequate milk if she’s tense and exhausted. Stress can also interfere with let-down, so try to do some serious relaxing before each nursing or breast stimulation session.

Image Eat right. Follow the Postpartum Diet (see page 665), being particularly careful to get enough calories and fluids and to take a vitamin-mineral supplement.

Image Don’t give up too soon. A pregnant woman’s body usually has nine months to prepare for lactation; give yours at least two or three months to get it going. Be persistent.

You’ll know your efforts are paying off if you feel the sensation of let-down in your breasts and your baby shows signs of adequate intake (such as contentment after feeding, wet diapers, frequent bowel movements). If he or she doesn’t appear satisfied, continue to use the SNS. (See page 164 for more on determining whether or not a baby is getting enough breast milk and on how to increase your milk supply if he or she isn’t).

If in spite of all your hard work you don’t succeed at producing milk, or don’t produce enough to make you the sole supplier of your baby’s nourishment (some biological mothers don’t, either), you should feel comfortable abandoning your efforts, knowing you and your baby have already shared some of the important benefits of breastfeeding. Or you can continue nursing largely for the pleasure it provides, supplementing your baby’s intake of breast milk, if any, with formula, either through the supplemental nutrition system or with a bottle.

GRANDPARENTS’ ATTITUDES

“My folks already have three grandchildren they dote on. I’m very upset that they don’t seem to be excited about the baby boy we’ve just adopted.”

It’s easy for your parents to become attached to their biological grandchildren. They’ve borne their own children and slip easily into loving the children their children have borne. But they may be a little unsure whether they will be able to love an adopted grandchild as easily or as well—even as many adoptive parents are unsure—and may stay aloof for fear they will fail. Perhaps, too, they haven’t yet resolved any feelings of disappointment (or guilt) they may have had about your not being able to conceive—they may even believe deep in their hearts that you still can. They may feel some anger if you’re adopting by choice.

It’s understandable that you feel hurt by your parents’ seeming lack of interest in your baby, but don’t be tempted to retaliate by excluding them from his life. The more you include them, the sooner they will grow to accept and love him.

Ideally, it’s best to involve grandparents in preparing for the arrival of their adopted grandchild just as they would be, or have been, involved in preparing for a biological one. Enlist them in shopping for furniture and a layette, in picking out teddy bears and musical mobiles. Consult with them on possible colors for the baby’s room, and on possible names for the baby. Choosing a family name for your child may make him feel more like “real” family to them.

After you bring the baby home, seek your parents’ advice on feeding and burping, bathing and diapering, even if you don’t really need it. If they live nearby, ask them to baby-sit when it’s convenient. If you’re planning a christening, ritual circumcision, or baby naming, invite them to play a major role in the planning and in the celebration themselves. If you’re not having a religious ceremony, consider having a “welcome baby” party for relatives and friends. Being able to show the baby off will make them feel more like grandparents.

If you feel comfortable doing so, talk to them about your perception of their feelings. Tell them that with this kind of new experience, uncertainties are natural—you’ve had some yourself. If they get a chance to vent their feelings, they may begin to feel more comfortable with them—and with you and the baby. If you can’t raise the subject, perhaps a respected relative, family friend, clergy member, or doctor can do it for you.

Most of all, give your parents plenty of time to get to know your baby; to know a baby is usually to love him. Be sure that you’re not being oversensitive or defensive, and just imagining that your baby is being treated differently. If in the end they still seem not to accept him fully, try to cover your hurt and keep family ties tied, with the hope that closeness will come gradually over the years.

UNKNOWN HEALTH PROBLEMS

“We’ve just adopted a beautiful little girl. She seems perfect, but I keep worrying that some unknown hereditary problem will surface.”

The genetic makeup of every child, adopted or not, is uncertain. And every parent worries occasionally about possible unknown defects. Fortunately, really serious genetic defects are rare and most parental worry unnecessary. It would be helpful to you, however, to get as complete a health history on both the baby’s biological parents if possible, to provide to the baby’s doctor and in case of future illness. Also try to arrange, when drawing up adoption papers, for some way to trace the adoptive mother (possibly by being supplied with her social security number if it’s a domestic adoption) so that should an unlikely crisis arise and your baby needs help from the birth mother (a bone marrow transplant, for instance), you would be able to find her.

But while an adopted baby is not any more likely to have an inherited disorder than is one who isn’t adopted, she is more subject to infection. Because she doesn’t come equipped with the same germs as her adoptive mother and father, she is less likely than a biological child to have antibodies to infectious organisms in her new environment. Take some extra precautions for the first few weeks, such as washing your hands before handling your baby, her bottle, or anything that may go into her mouth or come in contact with her hands, and by limiting visitors. Though the temptation to show her off is great, wait a few weeks before exposing her to large numbers of people. (She can use the rest, too.)

If your baby has come from abroad, she may also be harboring an infection or parasites that would be rare here. Her pediatrician should know her country of origin and should check her for diseases indigenous to that area of the world upon her arrival here. Immediate treatment of any problems uncovered will not only assure your baby of a good start in life, but it will also protect the rest of your family.

DEALING WITH FRIENDS AND FAMILY

“A few close friends knew we were going to adopt a baby. But now that she’s here we have to tell everyone we know. I’m not sure how to go about this.”

Whether they’ve adopted or delivered, the traditional way for new parents to spread their happy word is to send announcements to friends and family, and sometimes, to local papers. Exactly how you tell the world is up to you. Though you can specify in the announcement that your baby was adopted, you certainly don’t have to. Instead, you can introduce your baby as any other parent would. If she’s a newborn, you can announce her birth: “We’re delighted to announce the birth of …” If she’s an older baby, you can announce her arrival: “We’re thrilled to announce the arrival of …” or “We’re proud to announce that … has joined our family.” Either way, a picture will be worth a thousand words.

ADOPTION ANTIBODIES

If you’ve adopted an older baby, you’ll need to pay extra attention when it comes to vaccinations. Because some adoption agencies don’t have accurate records, it’s hard to know which, if any, vaccinations your child has already received. If your child has been adopted from abroad, he or she may not have received vaccinations on the United States vaccination schedule. Even if there is a vaccination record for your overseas baby, a foreign vaccination schedule is no guarantee that your child is adequately protected. That’s because the vaccines may not have been properly stored or administered.

To determine your child’s level of immunity, your child’s pediatrician can do a blood test to detect if your child has antibodies against a disease. If the test shows a lack of antibodies, the vaccine should then be given to your baby. Don’t worry about the potential of your baby’s being vaccinated for the same disease twice. Any adverse reactions (which are usually minor and quite rare) are still safer than contracting a disease.

Internationally adopted older babies will also need to be screened for a variety of infectious diseases such as TB and hepatitis B because they are at higher risk of having been exposed to such diseases.

When talking to anyone about your baby, start right off saying “our baby” or “my baby.” In referring to the parents who conceived her, use the words “birth” or “biological” parents, rather than “real” or “natural.” You are baby’s real parents, and the more you hear yourself say it, the more you—and everyone else—will come to accept it. If you have other biological children, don’t call them “my own” children or let other people refer to them in that way.

TELLING BABY

“Even though our son is still an infant, I can’t help worrying about how and when we’re going to tell him that he was adopted.”

It’s no longer a question, as it once was, of whether or not to tell a child that he was adopted. Today, experts agree that children need to know and have the right to know about their adoption, and should find out about it from their parents, not through inadvertent slips by relatives or friends. There’s also agreement that the best way to tell is by introducing a child, gradually, from infancy on to the fact that he was adopted—so he grows up completely comfortable with the concept.

You can start right now, while your baby is tiny and still doesn’t understand what you are saying. Just as a birth parent talks about the day her baby was born, you can talk about the day you brought your baby home: “That was the best day of our lives!” When you’re gurgling and cooing at him, you can say, “We made our family when we adopted you!” or “We’re so happy that we were able to adopt you and make our family!” Though your baby won’t be able to comprehend, even in the simplest terms, what “adoption” means until he’s three or four years old, early exposure to the concept will make it seem natural, and the eventual explanation of it easier to process.

SUPPORT FOR THE ADOPTING FAMILY

Baby on the way—or already arrived? Every new parent can use a little support (make that a lot), and adopting families can find it through these Internet resources:

Image www.adoption.org

Image www.adopting.org

Image Resolve (an infertility association that provides adoption information): www.resolve.org

ADOPTION BENEFITS

It’s a growing trend across the country—and this trend is a good one. Some family-friendly employers are beginning to recognize that parents who have adopted a child are just as entitled to benefits as are parents who have given birth to one. While the Family Medical Leave Act (FMLA) offers parents in large companies up to 12 weeks’ unpaid leave upon the birth or adoption of a child, these forwardthinking employers are going at least a step further—offering adoptive parents extra maternity and paternity benefits that parallel the ones they voluntarily offer birth parents, including paid leave. If your company doesn’t offer such perks for adoptive parents (check with human resources to see if it does), you might consider lobbying for them with other adoptive (or just plain supportive) parents.

Another way to help your baby learn about his adoption is to keep a scrapbook that commemorates it. You can include pictures and mementos of his first day with you and his homecoming—as well as some journal entries detailing the event and the emotions you were feeling when you first held him in your arms or first took him home. If you traveled to a foreign country for the adoption, the scrapbook is the perfect place to document the journey—and to give your son a glimpse of his heritage. If the adoption was open, photos of the birth mother (especially if they were taken with you, while you were both waiting for your baby’s arrival) can also help make the concept of your baby’s adoption more tangible to him. No matter what you include, looking at the scrap-book together is sure to become a favorite activity as your child grows—a special reminder of the special day that he came into your life and “made” your family.

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