FROM THE EDITORS OF

Welcome HomeA GUIDE TO BONDING WITH YOUR BABY AFTER ADOPTION

In a 2001 issue of Adoptive Families, author Judy Rader wrote: “For months the thought of adopting a stranger’s infant plunged me deep into the

despair that was my constant companion…. Yet a few weeks after our adoption, I

knew I was hopelessly smitten and forever changed. Still the thought came to me,

unbidden and slightly shameful: ‘I’m mothering someone else’s baby.’ Sometimes

I felt like an imposter…. Then came the watershed moment, our finalization court

date. When I woke up in a cold sweat at the thought of something going wrong

with the adoption, I realized how fully I felt myself to be Allison’s mother. And now

my attachment is so fierce, it takes my breath away. I have rocked her for a thou-

sand hours, kissed 10,000 boo-boos, answered a million “whys.” We have giggled

uproariously and snuggled together until we fall asleep. She is my daughter.”

If there’s one topic that prompts insecurity and anxiety among pre-adopters, it is that of bonding and attachment. Although, intellectually, wemay know what researchers have shown repeatedly—adoptive families formbonds as successfully and intensely as biological families—nagging doubtsremain. Will it happen in our family? Will we do something wrong in the earlyweeks or months that might impede attachment?

Although excellent literature on bonding and attachment with older chil-dren exists, there is remarkably little in the way of a roadmap for parentsadopting a newborn or a child under age one. With the notable exceptions oftwo excellent books from Perspectives Press (Launching a Baby’s Adoption andAttaching in Adoption), adoptive parents of infants are somewhat on their own.

The truth is that bonding is a process, a reciprocal process, which simplytakes time, in all families. As you’ll read in the pages that follow, attachmentemerges quite naturally through your very responsiveness to your child, asdescribed so vividly by Rader above. In this booklet, we focused on the first weeksand months after your baby comes home, with the ambitious goal of describingthe kind of baby care that enhances attachment in the adoptive family.

There is much more that we wanted to include, but space simply prohi-bited it. Please visit the Adoptive Families special Web site “Bonding with YourBaby,” at www.adoptivefamilies.com/bonding, for an extensive selection ofarticles on related topics, including:

>> the family bed and other sleep strategies>> Early Intervention programs>> welcome home and “gotcha day” celebrations>> breastfeeding the adopted child>> post-adoption depression>> telling the adoption story in scrapbooks and lifebooks>> how to talk about adoption from the earliest ages>> and much more….

I would like to thank our extraordinary team of writers, virtually all M.D.’sor Ph.D.’s, for their contributions to this Welcome Home booklet. MarybethLambe and JoAnne Solchany provided extensive information specific to adoptive families based on their years of experience, as did Deborah Borchers,Sarah Springer, Elliot Grossman, and Fran Eisenman. These committed individ-uals are breaking new ground in their practices with adoptive families and intheir writing about their findings.

Susan CaughmanEditor, Adoptive Families

Welcome HomeA Guide to Bonding with

Your Baby After AdoptionFrom the editors of Adoptive Families magazine

www.adoptivefamilies.com/bonding

EDITOR Susan CaughmanPUBLISHER Mark Gleason

CREATIVE DIRECTOR Mark GentileMANAGING EDITOR Eve Gilman

CONTRIBUTING EDITOR Rochelle Green

Writers: Marybeth Lambe, M.D., JoAnne Solchany,R.N., Ph.D., Sarah Springer, M.D., DeborahBorchers, M.D., Fran Eisenman, Elliot A. Grossman,M.D., Claire Houston

Adoptive Families (ISSN# 1076-1020) is publishedbimonthly by New Hope Media LLC, 39 West 37thSt., 15th Floor, New York, NY 10018.

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Welcome Home is a special publication of AdoptiveFamilies magazine. Copyright ©2005 New HopeMedia LLC. All rights reserved. Reproduction inwhole or in part without permission is prohibited. Web site: www.adoptivefamilies.com/bonding.

The information contained herein is offered onlyfor general information and does not constitutemedical or psychological advice. Adoptive Familiesdoes not endorse, test, or validate the products orservices offered by its advertisers or sponsors.Advertisements appearing herein do not representan endorsement by Adoptive Families, nor do theysignify an endorsement of or influence on AdoptiveFamilies editorial content by advertisers. Please donot act on the information herein without firstseeking the advice of your physician.

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Welcome HomeA Guide to Bonding with Your Baby After Adoption

TABLE OF CONTENTS:Meeting Your Baby . . . . . 4b

A Little Information Goes a Long Way . . . . . . 5b

Finding a Physician . . . . 5b

Post-Adoption Screening Checklist . . . . 6b

Your Baby, Yourself . . . . 6b

Feed Your Baby, Body and Soul . . . . . . . . 8b

12 Essential Feeding Facts. . . . . . . . . 8b

Connecting Through Everyday Baby Care . . . . 9b

A Good Night’s Sleep . . 10b

Adoption Basics for Family and Friends . . . 12b

The Ties that Bind . . . . 13b

Bookshelf Essentials . . 14b

Becoming a Mother . . . 15b

F I R ST D AYS

You’ve just met your baby andyou’re thrilled! You’re alsonervous, proud, frightened,

exhilarated, anxious, numb—youname it. An adoptive parent’s joyover a new baby is undeniable. Yet itmay be tempered by anxiety, partic-

ularly if your road to parenthoodincluded infertility struggles,dashed hopes, and financial strain.It’s also possible that you’re worriedabout bonding. I’m here to tell youthat these are all normal emotions,and that you will be fine.

Some parents feel an instantbond when they first meet and holdtheir infant. For most, however,bonding is a gradual process, takingweeks and sometimes months. Morethan 50 percent of adoptive parents,when asked to recall those first daysand weeks, report that they feltmore numb and scared than con-nected and competent.

You may meet your infant in ahospital room, a hotel room, an air-port, or at home, in a quiet room oramid a bustling group. Your childmay snuggle into your arms or pullaway and cry. Some infants becomewithdrawn and unresponsive, whileothers light up with a smile. Themore you’ve prepared by talkingwith other adoptive parents aboutthe wide range of experiences, theless likely you are to feel taken abackby your baby’s reaction.

All infants, even newborns,need time to adjust and connectwith a new environment and family.They may avoid eye contact, becomefussy, refuse to take a bottle, sleepexcessively or not at all. This hasnothing to do with your parentingskills or whether or not you gavebirth to this child. Only when, in avery rare occurrence, a baby refusesmost bottles and has fewer than sixwet diapers a day is there cause forconcern and medical attention. So,try to relax and give your baby time

Meeting Your BabyThe first few days with your new baby will bring a cornucopia of emotions. Here’s how to focus on whatcounts—bonding with your baby.

F I R ST D AYS

5B

to acclimate. These ideas can help:Appeal to your baby’s sens-

es. Hold off washing the outfit hecame home in, and keep it near himin the crib. Newborns are very sensi-tive to smell and can be comfortedby a familiar aroma.

Avoid excessive eye contact.Even a newborn will let you knowwhen it’s too much—he’ll look away,close his eyes, or fuss. Give him time.

Speak quietly and movewith gentle motion. Most infantswill startle at sudden movement.

Leave the room as little aspossible. If you can, stay in the hotelroom, rest, and hold your baby orrock or croon to him—these earlymoments of bonding are priceless.Try to avoid distracting visitors,noise, or commotion.

Snuggle up. Hold your infantas much as possible to facilitatebonding. A baby cannot be spoiledby too much holding time. Consider

a baby sling or front carrier; mostinfants prefer being securely swad-dled. Like a baby kangaroo, your

child will benefit from close contact. Be patient with yourself,

your spouse, and your infant.Caring for a new baby in a hotelroom in a strange city is exhausting.Give yourselves the gift of patiencewhile you adjust.

Know your doctor before-hand. You will have many questionsduring your first few days with yourbaby. So be sure, before your babycomes home, that you have a med-ical provider you can trust, one whowill take your calls from the citywhere you meet your baby. (Seebelow for how to find an adoption-sensitive doctor.)

Putting a diaper on backwards,fumbling with bottles and nipples,holding a slippery baby in bathwa-ter—these are common struggles inthe first days of parenthood. Relax.You will make many mistakesthroughout your child’s life. He willgrow and thrive and love you inspite of them.

Marybeth Lambe, M.D., is a family physi-cian and adoptive mother who lives withher family in Washington State.

A Little Information Goes a Long WayNow is the time to obtain and record information about your child’s past,while it is most accessible. Information you gather now may be precious inyears to come. Ask the child’s birth relatives about medical history, or hismost recent caretaker for eating and sleeping details. Do not trust your-self to remember what you hear—write it down!

1Your child’s recent eating and sleeping schedule. How much for-mula does she take and what kind? How does he like to be held or

comforted? Ask for names of caretakers. If not a newborn, has yourbaby ever been sick or in the hospital? Ask the caretaker if you cankeep the blanket or clothing you received your child in, and resist theurge to wash these clothes right away. The familiar smell may be acomfort to your infant in those first days.

2Record the medical details of your child’s birth measurements.Get the results of metabolic screening tests such as PKU or thy-

roid, information about developmental milestones, and all records ofimmunizations, transfusions, and past or present medications.

3Record as much information as possible about the age, health,and genetic origins of the birth parents and birth siblings. Ask

about genetic conditions in the family, such as diabetes, early-onsetheart disease, and breast or colon cancer.

4Write down a description of the birthmother’s pregnancy andlabor and delivery, including prenatal care, maternal lifestyle,

and infectious diseases; get the results of any lab tests during preg-nancy, such as maternal infectious diseases screening.

Choosing a doctor is a big decisionfor any family, and the choice isespecially important to adoptive

families. There are several steps you cantake to make your choice a good one.

Begin by asking your friends,neighbors, adoption support groupmembers, and adoption agency forrecommendations. With names inhand, check with the American Boardof Medical Specialties and theAmerican Academy of Pediatrics tofind out which doctors are board-certi-fied. Members of the American

Academy of Pediatrics’ Section onAdoption and Foster Care will beknowledgeable about medical issuesfor children adopted domestically,internationally, and via foster care.They have the knowledge to evaluatereferral information regarding birth-parent genetic history or substanceabuse, as well as the effect of institu-tionalization on child development.

Schedule a short visit to meet apotential doctor (as well as his officestaff), and ask some of the questionson the following page. Once you’ve

Finding a PhysicianAn adoption-sensitive pediatrician or family medicinephysician brings special expertise in caring for yourbaby’s medical and developmental needs.

At last, after months of wait-ing, your child is home.Adoptive parents may worry

that missing out on pregnancy ortheir infant’s first days or monthswill impede attachment. In fact, forboth biologic and adoptive families,attachment is almost always a jour-ney, not an instant event. It takestime to get to know your child, todevelop the rhythm and confidenceto parent. In these first days, it isvital that you take care of only theessentials—your partner and yourbaby. Avoiding other claims on yourattention will enhance your ability tobond. Much as you want to show offyour new baby, use the first weeks to

get acquainted at your own pace. Remember that, in these first

weeks, you and your baby are intransition. You’re not yet familiarwith your child’s cues or the mean-ing of his cries. You may feel clumsyat holding, making bottles, burp-ing, bathing, diaper changes.

There is extraordinary joywhen you first learn that, afteryears of longing, your baby is wait-ing for you. Don’t be surprised if it isimpossible to sustain such joy.Disappointment is very commonafter attaining major milestones.Like bio parents, some adoptive par-ents will experience a post-adoptiondepression as a result. (See www.

chosen a doctor, decide whetheryou’ll consult your doctor or an adop-tion specialist to evaluate your child’sreferral information or to reviewbirthparent medical history.

Once your baby is at home, makesure that all appropriate post-adop-tion screening is carried out uponyour child’s arrival home (see box).

In subsequent visits, you’llwant to know that your child isreaching developmental milestonesat the appropriate times. In adop-tions where no genetic history isavailable, you’ll want a medical pro-fessional with first-rate diagnosticskills to focus on areas of possibleconcern. The medical professionalwhom you select will be involvedthroughout your child’s growingyears, so you, and your children,will need to be comfortable withhim or her as your child grows.

Compiled from articles by Elliot A.Grossman, M.D., Deborah Borchers, M.D.,and Marybeth Lambe, M.D.

6B

Your Baby, YourselfYour baby needs your full attention now. Here are sometips for keeping happy, healthy, and focused on thenew priority in your life.

QUESTIONS TO ASK APOTENTIAL FAMILY DOCTOR

1What is your philosophy aboutantibiotics?

2What is your philosophy about vaccinations andimmunizations?

3Do you have daily phone-inhours?

4Who covers for you when youare on vacation?

5How do you feel about raising a child as a vegetarian?

6What is the average wait forwell-baby appointments?

7To whom do you refer childrenwho are developmentallydelayed?

8Describe your medical trainingand special areas of interest.

✔ DISEASE SCREENS: Reviewrisks of sexually transmitteddiseases as well as blood-borne pathogens. Screen forhepatitis B surface antigen,hepatitis B surface antibody,and hepatitis B core antibody.Test for syphilis, hepatitis C,and HIV.

✔ STOOL EXAMINATION: For ovaand parasites, giardia anti-gen, and bacterial culture.Three specimens, obtained 48hours apart, are strongly rec-ommended.

✔ BLOOD COUNT: Hemoglobinelectrophoresis is recom-mended for children who areanemic and at risk for abnor-mal hemoglobins—those ofAfrican, Asian, orMediterranean descent.

✔ LEAD LEVEL TESTING

✔ METABOLIC SCREEN: Includethyroid testing (TSH).

✔ TUBERCULOSIS TESTING(PPD): A test of 10 mm is

considered positive for chil-dren adopted internationally.Prior BCG immunization is nota contraindication for TB test-ing, and results should be readas if no BCG had been given.

✔ URINALYSIS DIPSTICK

✔ IMMUNIZATION CHECK:Validate immunizations forchildren adopted domestical-ly. For those adopted interna-tionally, most immunizationscan be repeated without harm.

✔ EVALUATION OF DEVELOPMENT

✔ VISION AND HEARINGSCREENING

✔ REPEAT TESTING: Six monthsafter arrival in the U.S., chil-dren adopted internationallyshould have repeat testing forhepatitis B and C, HIV, and TB(with a repeat PPD test).

From the American Academy of Pediatrics Red Book.

Post-Adoption Checkups

adoptivefamilies.com/bonding formore on this topic.)

Strategies for the firstfew weeks:

Limit visits. Your baby needstime to bond with you, unencum-bered by distraction. Unplug thephone or leave a voice message ifexcited friends keep calling.

Get help. Hire out the house-work, lawn mowing, or cooking. Askfriends to fix meals, run errands,shop, and care for your other chil-dren. The less you have on yourmind, the more attention you canpay to your baby’s well-being.

Get support. Join an adop-tion support group, if you haven’talready. Share your feelings withothers online or in a community set-ting. Some adoptive parents areembarrassed to complain to friendsand family about baby’s crying,colic, or diaper rash. “I felt like peo-ple would say that I asked forhim....” Adoption counselor profes-sionals can be an enormous aid, too.

If you are feeling unsure aboutcaring for your baby, attend an

infant care seminar hosted by a hos-pital or adoption agency. This isyour chance to get “hands-on” expe-rience. Many hospitals and publichealth agencies can arrange to havea nurse visit your home and giveone-on-one instruction.

Make things cozy, not fancy.Infants don’t care about an elegantnursery. All they need is to be safeand loved and warm. Be sure thatyour baby’s crib or bassinet (as wellas her car seat) meets the highestsafety standards. To reduce the riskof SIDS (crib death), always put yourchild to bed on her back.

Take care of yourself. Even a15-minute walk around the block or20 minutes of yoga can help you relaxand clear your mind. Try to eat well.

Get some sleep! Exhaustioncan make those first weeks evenharder. Sleep when you can—prefer-ably, whenever baby naps.

You may decide to keep yourbaby in the family bed for the firstweeks. If so, do not use a waterbedor soft bedding that could smothera child. If you can’t get sleep wellwith your baby in the bed, try a

bassinet or crib that attaches toyour bed. (An example may be seenat www.armsreach.com.)

Hang on to your sense ofhumor. Raising children is seriousbusiness, but you have to laugh atyourself or you are finished.

Take everybody’s advice,even mine, with a grain of salt.Sister, friend, doctor, mother-in-law—all will tell you what to do.Follow your own instincts abouthow to raise your child. Even as anew parent, you can trust that gutfeeling about your baby.

By Marybeth Lambe, M.D.

F I R ST D AYS

7B

10expert-devised,baby-approved waysto form a loving bond

1Wear the baby in a chest carrieras much as possible so he can

hear your heart beat.

2 Associate food with comfort byholding, rocking, and singing to

your baby while you feed her.

3 Become your baby’s primaryprovider of care, meeting all

her needs yourself, to build trust.For now, encourage friends andrelatives to leave the hugs andkisses to you.

4 Maintain your baby’s familiarroutines as much as you can.

5 Make a tape of your voicesinging and play it at nap time,

bedtime, or in the car.

6 Bathe together to promoteskin-to-skin contact.

7 Keep any clothes or blanketsyour baby came with for their

soothing smell.

8 Delay visits to shopping mallsand other stimulating places

for a few months.

9 Daily massages can increase achild’s comfort with your feel

and your smell.

10Let a nurse hold your child foran injection, then you com-

fort her afterwards.

F I R ST W E E K S

8B

All new parents have questionsabout feeding. For adoptiveparents there is more to con-

sider than just nutrition. Feeding isa powerful way to meet your child ‘sneed to survive and demonstratethat you love her and will always bethere. Feeding offers you the oppor-tunity to connect with your baby ata most basic level. Here are someguidelines to help you make themost of your mealtimes:

While feeding, hold yourbaby close, and turn her toward you,so you can see each other. Neverleave your infant with a proppedbottle; she will miss your comfortand warmth. Make eye contact. Sitface to face, whether during bottle,highchair, or table feeding.

If possible, continue with theformula and bottle your baby wasusing before he came to you. If ababy refuses a new formula, intro-duce it gradually by mixing it withthe old formula. Introduce strainedfoods one at a time.

Babies who’ve lived inorphanages will often drink hugeamounts of milk and eat a greatdeal of baby food in the first weeksor even months after adoption. It isvery important to allow your childto eat as much as she desires, asoften as she desires. She’ll learn tostop eating once she trusts thatthere will always be food, that youwill always provide what she needs.

Make frequent connectionswith your baby through your gaze,

your smiles, and your praise. Talk toyour baby, “Isn’t that milk good? Isit warming your tummy?” To a tod-dler, you might say, “These carrotsare so good, can you taste the sun-shine in them?”

Some adopting mothers suc-cessfully breastfeed their newbornsor older infants, usually supple-menting their own breast milk withformula. Talk with a lactation con-sultant to decide if this option isright for you.

Many orphanage babies arefed through propped bottles, and, asa result, some have underdevelopedmuscles for sucking, or swallowing.This is best remedied early with thehelp of an experienced pediatricfeeding expert. Consult your earlyintervention team.

Respect your child’s cues.Babies and toddlers often turn theirheads, pull away, spit out their food,or begin to throw pieces of theirmeal on the floor when they wantto take a break.

By Sarah Springer, M.D., JoAnne Solchany,R.N., Ph.D., and Marybeth Lambe, M.D.

Feeding Your Baby, Body and SoulMeals are a chance to both nourish and nurture yourchild. What you put in the bottle is only the beginning.

�Silicone nipples (not latex), are preferred. They aredishwasher safe, allergy-free, and less porous thanlatex. (But many newborns prefer latex.)

�Choose a bottle that minimizes the extra air thatyour baby takes in during feeding. Try those withplastic liners or angled bottles.

�If you have a safe water source, such as city tapwater, it is not necessary to use sterilized water tomake formula or clean bottles and nipples.

�Running the bottle equipment through hot soapywater or using the dishwasher is generally sufficient.

�Be very careful if heating a bottle in themicrowave. Always check the temperature of the milkby pouring a few drops on the inside of the wrist.

�Always choose iron-fortified formula to preventanemia. Getting enough iron in the first year of life iscritical. It’s a myth that iron-fortified formula caus-es constipation or other digestive problems.

�Babies under age three are rarely lactose-intoler-ant; cow’s-milk formula is commonly used.

�If your baby has colic, excessive spitting-up, diar-rhea, constipation and gas, call your family doctor,but know that colic occurs in at least 30 percent ofbabies, and that almost all babies spit up regularly!

�Feed your baby in a secure position with her headraised. Make sure your baby’s head is higher than herhips, so it is easier for her to swallow.

�Hold the nipple steady, and tilt the nipple toensure that your baby takes in less air with the formula he drinks.

�Feed your baby as much as she wants each timeshe wakes and seems hungry. Bottle-fed babies usu-ally want to eat every three to five hours.

�Look for signs the baby has had enough. He will pullhis body back, pull away from the nipple, or twist hishead away. Do not force your baby to finish a bottleif he is no longer hungry. Throw away any formula hedoesn’t drink. (Germs grow in warm milk.)

Marybeth Lambe, M.D., is a physician and adoptive mother inWashington state.

12 Essential Feeding Facts Parents Should Know

Attachment and adoptionseem inseparable to manyparents. In fact, attachment

is an ongoing process for all parentsand children, one that generallytakes from 10 and 14 months andcontinues to evolve over a child’searly years.

Attachment is rooted in a child’sneed to be fed, bathed, kept warm, tosleep, in order to survive. As a parentmeets these needs, attachment isformed. Consistency, predictability,and emotional responsiveness createsecure attachment.

Consider that a baby requiresmore than 3,000 diaper changesand eats over 6,000 times during thefirst three years of life. Add 2,000

going-to-sleep times, 2,000 or somorning and naptime wake-ups,1,000 bath times, and 2,000 gettingdressed times. These are themoments (the glances up at mom ordad, being held when tired) to con-nect, establish trust, and strengthenyour bond with your baby.

Making the most of everyday moments

1Always be there. Your babyneeds to know with certainty

that you will come when she needsyou. A good rule of thumb: No mat-ter what your child’s age at adoption,respond to his cries or call verbally orphysically within 15 seconds.

2Talk to your baby.Try to maintain eye

contact. Make upgames—peek-a-boo, I’m-gonna-get-your-belly -button.

3If your child avoidseye contact, slowly

coax the behavior overtime (not forcing butnot ignoring the behav-ior either). Play “I seeyou,” peeking, makingeye contact, and thenhiding again. Smile orlaugh. Playful interac-tions decrease feelingsof threat and make time with you fun andrewarding.

4Touch your child. Apat on the arm, a

kiss on the head, a tickle on thetummy: Connect through the spon-taneous touches that occurthroughout the day.

5Keep it playful. Any momentcan be fun with a song, a game,

a laugh, or just a smile. The more achild associates positive feelingswith being fed or changed orwarmed or comforted by you, thestronger the developing parent-child relationship.

6Do not take your baby’s behav-ior personally. Babies who are

fussy eaters, who flail around dur-ing a diaper change, or pull awayduring your attempt to connect areusually tired or overwhelmed. Don’tinterpret a baby’s withdrawal as arejection of you or a desire to bewith a previous caregiver. Stay closeto him physically, as well as withyour voice and your gaze.

7Think like your child. Ask your-self, “What would this look like

from my child’s point of view?”

F I R ST W E E K S

9B

Connecting ThroughEveryday Baby CareDressing, feeding, burping, tickling, tucking into bed—the nuts and bolts of baby care bring the moments thatcan draw you together.

F I R ST YE A R

Don’t assume that your child isexperiencing events as you do.Instead, consider his perspective. Goslowly; don’t push.

8Demonstrate Attachment.Behave as if your baby respond-

ed to you the way you expected. If heturns his head away when you pickhim up, act as if he had looked atyou, reached for you, and smiled.Walk into the room, looking right athim, with arms open, smile, and saylovingly, “There you are! I’ve beenwaiting for you. Look, my arms areready to hold you.”

9Maintain Physical Connection.Hold your baby, wear your baby,

hand in hand, skin-to-skin. Soft babycarriers keep your infant close toyour body. An older baby can adaptto a sling carrier. Keep toddlers closeby holding hands or keeping yourarm around them. Carry an olderchild to bed or in from the car. Givepiggyback rides. Cuddle and rock.

10You cannot spoil a baby! Themore you respond, the more

secure your child, and the moreindependent he will become later.Respond to a crying baby and thebaby cries less over time. Respond toyour child and you will see fewerbehaviors designed to gain yourattention. Your interactions willbecome richer and deeper.

Think of each time you care foryour baby as an occasion to meetbasic needs and to connect. By let-ting your baby know you are thereto nurture her, by providing affec-tion, happiness, and a sense of well-being, and by developing a relation-ship of give and take, you will estab-lish a foundation for lifelong attach-ment with your child.

JoAnne Solchany, R.N., Ph.D., is an assis-tant professor at the University ofWashington in Seattle.

F I R ST W E E K S

10B

A Good Night’s SleepHow to Respond to Your Child’s Night Wakings and Help Her Sleep Through the NightAll parents long for a peaceful bedtime routine: Read your child astory, kiss her goodnight, and don’t see her again until morning. By understanding how children learn to sleep through the night, youcan help your child sleep, as you promote her attachment to you.

Newborns learn to sleepthrough the night by consistentnurturing and neurologic mat-uration. Initially, you’ll respondto your newborn many timesduring the night. After provid-ing food or comfort, let herdrift off to sleep in her crib byherself. By about 6 months ofage, she should be able to fallasleep on her own and sleep for10 to 12 hours, feeling safe inthe knowledge that you’rethere if she needs you.

A child adopted as an olderinfant or toddler may not haveslept alone before, and, fearfulof the strange sights, sounds,and smells of her new home,may wake up crying repeatedlyin the night. To sleep throughthe night, she needs the con-solation of having her needsmet consistently by the sameperson. Think of your child as anewborn in a toddler’s body.Meet each of her needs, suchas pain, hunger, fear, or sensory aversions, in the appropriate way.

See a sleep specialist if your child snores persistently, has difficultybreathing, or exhibits unusual movements during sleep.

Be wary of advice from well-meaning friends and relatives to “lether cry it out.” For a scared and uncertain child, this will only reinforcethe notion that nighttime is scary and lonely.

A good rule of thumb: Be as physically and emotionally present asshe needs you to be, but keep that presence as limited as she’ll toler-ate. You may need to sleep in the same bed for the first few weeks,then on a mattress in her room, then just outside her door. Wean your-self from her sleep routine as she learns that you’ll be there when sheneeds you. It may take months, but your efforts will pay off. Your childwill soon be sleeping peacefully through the entire night, and you’llhave formed an attachment that will last a lifetime.

Sarah Springer, M.D., is the chair of the AAP Section on Adoption and Foster Care and medical director of International Adoption Health Services of WesternPennsylvania in Pittsburgh.

1-4 wks 18-22

1-4 mos 16-20

4-12 mos 14-18

1-3 yrs 12-14

3-6 yrs 10-12

7-12 yrs 9-10

hours of sleepneeded dailyage

AGE-BY-AGE SLEEP NEEDS

Part of the joy of bringinghome our children is sharingour happiness with others. So

we’re sometimes caught off guardby insensitive, even rude, questionsand comments from family andfriends. How to respond?

1Protect your child’s privacy. Inthe excitement of the moment,

it’s easy to reveal too much aboutyour baby’s background. This isyour child’s private history, and heshould decide whether and when todivulge the story of how he came tobe adopted. You do not have toanswer every question that is asked,and you should never share any-thing that your child herself doesnot already know. Often, non-specif-ic details will satisfy idle curiosity.

Privacy means offering per-sonal details only to thosewho need to know. Secrecyinvolves shame, and thereis no shame in adoption.

2Practice the right lan-guage. Now’s the time

to learn what to say to oth-ers about adoption. Yourbaby doesn’t understandwords yet, but she’ll pickup on your tone, so keep itcomfortable and relaxed.Soon enough, she’ll beginto understand your words,as well, so start practicingyour responses to questionsand comments now.

3Be a teacher. You canhelp others under-

stand what it means toform a family throughadoption and clarify their

misconceptions. Asking “Why doyou ask?” will silence some andreveal the sincerity of those whoreally want to know more aboutadoption. If questions are too intru-sive, you can say, “I’m sure youunderstand that the informationyou seek is personal to our family.”

Remember, we respond to thesestatements in order to help our chil-dren deal with such comments inthe future. And what better time tolearn to speak about adoption? Youget to practice saying what you wantyour baby to understand when she’solder. As she grows, she’ll know howproud you are of the way youbecame a family.

Marybeth Lambe, M.D., is a family physi-cian and adoptive mother in Washingtonstate.

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Questions YouMay Hear...

and how to respond.

QUESTION: “Her real motherwas a teenager, right?”

IMPLICATION: Birthmothers aremostly troubled teens.

YOUR RESPONSE: We’re keep-ing information about Janie’sbirth family private right now.

QUESTION: “How could anyonegive up such a beautiful child?”

IMPLICATION: Birthmothers areirresponsible and heartless.

YOUR RESPONSE: Her birth-mother couldn’t raise any childright now. It must have been adifficult decision.

QUESTION: “What do you knowabout her real parents?”

IMPLICATION: Adoption infor-mation is publicly available.

YOUR RESPONSE: We’re hisparents. We’re bringing him up.

QUESTION: “It’s too bad youcouldn’t have your own child.”

IMPLICATION: Adoption is second-best.

YOUR RESPONSE: Janie is ourown child.

QUESTION: “Aren’t you worriedthat his birthparents will comeand take him back?”

IMPLICATION: Birthparentsmay appear to “reclaim” theirchildren at any time.

YOU RESPONSE: No. We’reMichael’s family by law.

QUESTION: “How much did youhave to pay?”

IMPLICATION: Adoption is out-rageously expensive. Babiescan be bought

YOUR RESPONSE: Adoptionfees are all court-approved.After tax credits and employeebenefits, adoption isn’t muchmore expensive than childbirth.

Adoption Basics forFamily and Friends As they welcome your baby, help your family under-stand adoption at the same time.

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Rituals remind us to connectand celebrate. The special rit-uals we create reflect the love,

comfort, and attachment that gluefamily members together. Our chil-dren relish rituals to celebrate thewonderful way our families areformed, such as coming-home(“gotcha day”) celebrations, the cre-ation of adoption lifebooks, and tra-ditional tellings of “the day we metyou.” In the same way, activities thathonor birth culture can create astronger and more positive identity.

Involved from the Get-GoBabies are constantly learning andmaking memories, so involve yourinfant or toddler infamily rituals early on.Let him touch and seethe adoption-journeyphoto album you’remaking for him. Tellhim (and siblings) hisadoption story overand over to create anew family ritual.

By surroundingyour baby with familytraditions, you showhim that he belongs toa family and a society,and that he is and willforever be cherished.

And BabyMakes…aNew TraditionAny emotional, mean-ingful activity canbecome a cherishedritual. Along withWelcome Home daycelebrations, try these:

Start a lifebook for yourbaby, and add to it every year. Pick aregular time, e.g. the anniversary ofher placement or finalization day,to read and discuss it.

Say a blessing for your baby’sbirth family before meals or whenyou light holiday candles.

Once a year, in your baby’sname, donate something to anorganization that supports adop-tion. Tell her you are doing this tohonor her and to help others.

Create a memento box. Starta collection of items, tokens, or pic-tures that represent your child’sadoption and/or birth culture, andadd to it regularly. Your child candraw or paint a picture or record a

tape to add to it. Be creative!Celebrate Family Night. Set

a night once a month to recognizethe importance of family bonds.Activities could include a specialdinner, games, birth-culture activi-ties, looking through photo albums.

Hand down a tradition. Forexample: “When I was little, I bakedthese Christmas cookies with mymom. Now we do it together.”

Fran Eisenman is a family counselor spe-cializing in adoption. Dr. JoAnne Solchanyis an assistant professor at the Universityof Washington.

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The Ties That Bind Rituals are the glue that binds a family together.

How to Create aSimple AdoptionStorybookWith the adoption processfresh in your mind, now’s thetime to create a child-friendlyphoto book describing yourchild’s adoption. Keep it simple—one photo or item perpage, accompanied by one ortwo sentences of straightfor-ward text. Laminate the pagesand read it at bedtime fromthe earliest ages. Includethese pages:

1Where it all began: Helpyour child “see” her begin-

nings by including photos ofher city or country of birth.

2Before baby: Include somephotos from your own life

before the adoption.

3Working our way towardyou: Briefly describe the

adoption process, and includea referral photo or a photofrom your first meeting withher birthmother.

4Meeting you: Was it a sunnyday? What do you remem-

ber about the hospital ororphanage? Enrich this sectionwith any special details youremember.

5Coming home: You can endthe storybook on the day

you met your child.

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BOOKS FOR PARENTSLaunching a Baby’sAdoption: PracticalStrategies for Parents and ProfessionalsBY PATRICIA IRWIN JOHNSTONPerspectives Press; 1998

Patricia Johnstonaddresses thequestion everyparent has aboutbonding afteradoption. Afterreading thisbook, you’ll feelconfident that

your new relationship with theinfant you’ve adopted is on trackand that your baby will have the bestpossible start in life. A must-read forevery parent, or soon-to-be parent, ofa baby adopted under age one.

Raising Adopted Children: Practical,Reassuring Advice for Every Adoptive ParentBY LOIS RUSKAI MELINAPerennial; 1998

Lois Melina is aninternationallyrecognizedauthority on rais-ing adopted chil-dren. In this clas-sic parentingmanual, Melinaholds parents’

hands every step of the way, fromannouncing your adoption andchoosing a pediatrician to bondingwith your child, creating lifebooks,and talking to your children aboutadoption.

Attaching in Adoption: Practical Toolsfor Today’s ParentsBY DEBORAH D. GRAYPerspectives Press; 2002

Deborah Graysets out—instraightforward,unthreateninglanguage—practi-cal tips forresponding tothe challengeschildren face

when they leave one home (theirbirthparents’, their orphanage) andenter another. Gray’s approach ispositive and realistic, providingclear explanations of developmentalstages and checklists to help parentsassess how their child is doing.

INTRODUCING THE ADOPTION STORY TO A YOUNG CHILDThe Day We Met YouBY PHOEBE KOEHLERAladdin; 1997

Beginning with “The sun shonebright the day we met you,” thislovely tale focuses on the first meet-ing between parents and child. Toldin simple language, with soft pasteldrawings, The Day We Met You is theperfect book to read aloud from theday you first meet your baby.

Tell Me Again About theNight I Was BornBY JAMIE LEE CURTIS; ILLUSTRATED BY LAURA CORNELLHarperTrophy; 1996

In this sweet, funny tale, a younggirl requests a telling of her adop-tion tale—and ends up demonstrat-ing that she already knows it byheart. More than the story of herbirth and domestic adoption, it isthe story of how her family was cre-ated, and it makes for delightfulbedtime reading. Curtis’ charmingtone and Cornell’s colorful, wittywatercolor illustrations make thisone a keeper for years to come.

I Love You Like Crazy CakesBY ROSE LEWIS; ILLUSTRATED BY JANE DYERLittle, Brown; 2000

Based onthe author’sown experi-ences, I LoveYou LikeCrazy Cakestells thestory of asingle

mother’s adoption from China.Because it’s told from a mother’spoint of view, the book does a won-derful job of conveying the bondthat quickly builds between parentand child. Dyer’s lush, delicate illus-trations perfectly complement thesentimental text.

Bookshelf EssentialsKeep these 6 adoption classics close at hand.THE EDITORS OF ADOPTIVE FAMILIES

Somewhere alongthe way, between“gotcha” and today,I became her moth-er. It’s hard to say

when. The day I first saw her,I was an independent, 44-year-old woman, and she was acute, 10-month-old, baby girl.Now, when I look at her, Iknow that I am her mother,and she is my daughter.

After a year-and-a-half andmountains of paperwork, achild was placed in my arms.We were strangers. She wasleaving the known world of her foster home, and my husband and Iwere taking on this unknown babyfrom an unfamiliar land whereCaucasians are rare.

We retreated to our hotel roomand began to play house. It felt thatstrange. We knew four things abouther needs: food, diapers, stimulation,and sleep. We began to go throughthe motions of all four, and, severalhours later, collapsed into bed,laughing quietly. She was soundasleep as we remembered theTalking Heads’ lyrics, “My God, whathave we done!” We weren’t confidentabout our parenting skills, but,somehow, it all worked.

More days of meticulous paper-work ensued—interviews, signatures,passports—to prove that we were whowe said we were. My husband and Itag-teamed very well, but still, we feltwe were spectators to this little girl.

During the adoption process,you spend a lot of time saying overand over to officials that you wantthis baby, that you will treat her like

gold, and you promise never to aban-don her. Then, you finally get thebaby, and all the hoops disappear.The reality of this being’s presencebegins to come into focus. Yet I con-tinued to feel more like a curiousobserver than a mom.

A loving homecoming at the air-port brought friends and family outto celebrate our return to Americansoil. We entered our house to findballoons, gifts, meals in the fridge,and plenty of good wishes. The babygirl looked around, then smiled. Sheliked the house that she would soonlearn was her new home.

Jet-lagged and sick, I had troublefeeling like I was myself, let alonefeeling like a mother. But, slowly,new routines began to emerge athome. My husband and I marveled ather intelligence, at how fast shelearned and applied her learning.She laughed. She laughed a lot. Wecould see that she was a happy girl.

It was delightful to engage withher and get the reward of a baby’sbelly laugh. She liked to see that sh

could make us laugh. Days slippedby, and our souls were secretly beingwoven together.

I saw the first glimpse of thiselusive bond about a month after herarrival. Acquaintances stopped by togive her a gift, yet they seemed moreattentive to each other than to her.She handed them her favorite toys,and they absently took them and putthem down. She played peek-a-boowith them, and they vaguely partici-pated. She looked somber. At first, Ididn’t think much of it, but, after awhile, I noticed a dulling of her eyes.

I swept her up and announcedthat we had to make dinner. Ourguests departed, and I turned my fullattention to her. We looked at hertoys and our cats, and played peek-a-boo in earnest. We laughed together.Her light quickly returned.

A similar encounter happenedthe next day, and I felt, deep in mygut, a vow emerging. “I see you, deargirl. I see your light, and you seemine. I will guard and steward thatlight. Fear not, I won’t let them swallow it up.”

I was surprised by the fiercenessof these feelings. And then I under-stood: I had become Mom to Evie.

A definitive peacefulness has fol-lowed that realization. I am clearabout my purpose with this littlegirl. And I recognize the mother lion-ness in me. The mysterious bondingthread has formed, and although weare not genetically formed, one fromthe other, genetic programming haskicked in. I am genetically pro-grammed to take care of this babyhuman, and she is genetically pro-grammed to bond with me, hermother. All is well with the world,and working perfectly.

Claire Houston is the director of The WomenSupporting Women Center, and sees adultsin her private psychotherapy practice inExeter, New Hampshire.

Becoming a MotherIn this personal essay, the author reflects on the surprising fierceness of feeling like a mom.CLAIRE HOUSTON

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