A Guide to Fostering Babies

• 
• Author:FosterWiki
• Published:October 2022
• Country:

A Guide to Fostering Babies

Below is a brief guide to fostering babies and some useful top tips.

Introduction to Fostering Babies

As foster carers you will you are expected to be always professional, your feelings or that of your family are not the focus.

You will find it difficult when any child moves on and this will impact you as well as your family, this is especially true when babies you have had from birth move on, you will have built up a strong bond throughout their time with you as they are reliant on you for all their needs. Some Las & IFAs will offer support, although this can be in the form of a short break or a chat.

From the start, you must be aware that your role is to love nurture and give these babies the best start possible in life and then they will move on. You might not agree with the panels or the court’s decision for them to return to their birth family or move on to adoption, it is not part of your role, and this can be stressful no matter how many times you go through the same process.

Placement Plan

The placement plan should be agreed upon before the baby is in your care, this is the time to ask questions about what is expected of you regarding contact time with parents, who are the key personnel involved with the child, for example, who is the IRO, who are the birth families, what the parents wish to happen with the child, reunification, adoption etc.

You will find out who the Child’s Social worker is (CSW) and what are their contact numbers for them.

You can also ask questions about queries you have on the profile (Matching) document if you were provided with one. Sometimes placement meetings are held within the first few days and other times this might be after you have the child in your care.

This is the time to confirm who will be registering the baby with the doctors when contact will be carried out, what visits are to be expected to be done and by who. Always good to get a date and time confirmed in this meeting for any visits and the next Looked After Child (LAC) meeting.

Please note that placement meetings can be carried out in the neo-natal units with parents present, this can be tough on you as well as the parents.

Picking the child up from Hospital & pre-discharge visits

You might be asked to pick the child up from the hospital, this can be a tricky time as birth parents might want to find out who you are.

Normally the CSW will be present if they foresee any problems and will possibly drop the child off to you. Check with the nursing staff who is present and if needed enquire with them what time would be more suitable to pick the child up.

If you are visiting the child before discharge gets to know the nurses and midwives they are the best source of knowledge about the baby and ask questions. You might need to arrange times to visit whilst the parents are not present.

Equipment needed when Fostering Babies

Like all parents, you can over-purchase equipment, ensure you have the basics, such as sterilisers, pushchairs, bottles, bibs, muslin cloths, baby baths, sleeping bags, Moses baskets, suitable car seats, blankets, and appropriate-sized clothing.

You can normally get an allowance from the CSW/SSW for equipment purchases; however, they do have a limit, you might also be issued with equipment such as cots, pushchairs etc from your provider.

If you are fostering babies only, you will be better off investing in equipment that will not wear out after six months, for example, a sturdy plastic easy to clean Moses basket will last a lot longer than a wicker basket, and it is easier to clean between children (Replace mattress if necessary for each child) and will be more robust, normally about the same price or cheaper than traditional baskets.

Do not feel bad about hand-me-downs, store clothes by age and gender. They are in them for such a short period and will come in handy if you have an emergency placement.

Clothes and equipment are given by birth families

Clothes and items given by birth parents; can mount up as you will find that they are sometimes not the right size. Always offer the birth parents the opportunity to have them returned, they might be able to exchange them for a different size.

If you are receiving items of clothes or toys from the parents or Child Social Worker (CSW) then make a note in the diary of what has been received and from who. If you are handing back or enquiring what they wish to do for clothing that is too small or large then put it in the contact book and ask them to confirm their wishes.

Not all items are suitable for a child to have, examples will be age-appropriate toys. Keep a note of the item, do not give it to the child but keep it safe to either return to the parents if the child is returned home or to move on to the adoptive parents in the future. Drop the CSW an email if this happens.

Ensure all clothing, blankets are clean and free from odours. If you do find a problem put it in the diary and clean the item. (Clothing can smell of tobacco).

Keep in mind the child’s memory box for keepsakes, “My first teddy bear or my first outfit”.

Try and dress the baby in the clothes provided by the parents on contact sessions, this is important for the parents as they can feel like they have an input into the child’s life and a bond with them.

Health & Care Birth Parents

Probably the most contact you will have with birth parents as they have a right to attend medical appointments.

Known Health problems within the birth family

This is especially important to ensure you can be aware of potential problems with the baby as they develop in their early years. See what is on the medical discharge notes, and speak to the birth parents, do they have allergies, genetic issues such as KIF 11, heart defects etc…

Make sure that you convey any information to all the health professionals you will be working with such as the GP, Midwife and Health Visitor. Also, make a note on the diary sheets (Discussed later in this document) and keep the Childs Social Worker (CSW) informed.

Fostering Babies with Foetal Alcohol Syndrome

As a foster carer involved with the care of babies you will likely be faced with the possibility of Foetal Alcohol Syndrome (FADS). Knowing the basics of what it is and what to look for is important, it is recommended you request from your Supervising Social Worker(SSW)/Link Worker training within this area.

A child with FASD might present with some of the following symptoms:

• Low body weight.
• Difficulty with attention.
• Speech and language delays.
• Sleep and sucking problems as a baby.
• Vision or hearing problems.
• Problems with the heart, kidneys, or bones.
• Shorter-than-average height.
• Small head size.
• Abnormal facial features, such as a smooth ridge between the nose and upper lip (this ridge is called the philtrum).

Although these symptoms are not always connected with FASD you should mention any abnormalities with the GP at the 8-week appointment stage or earlier.

Support networks recommended by the NHS for FASD are:

• FASD Network UK (http://www.fasdnetwork.org/)
• National Organisation for FASD (https://nationalfasd.org.uk/)

Fostering Babies with Neonatal Drug Withdrawal Symptoms

Neonatal drug withdrawal symptoms, also known as Neonatal Abstinence Syndrome (NAS) is a common condition seen in infants born to mothers who are dependent on certain drugs (e.g., those addicted to heroin and methadone).

Normally you will be made aware that the baby is withdrawing from drugs by the hospital, symptoms can last between 1 week and 6 months in most cases.

However, not all babies are discharged to the foster carer directly from the hospital and you may not have the medical discharge notes.

Below are the signs the baby is withdrawing from drugs and what to expect:

• Prolonged crying (maybe high-pitched).
• Sleeplessness.
• Excessive sucking of fists.
• Difficult or poor feeding.
• Sneezing, stuffy nose or breathing troubles.
• Vomiting.
• Hyperactivity.
• Trembling.
• Fever (temperature over 37 °C).

If the baby is presenting these symptoms, please seek medical advice by calling 111 or your GP/Health visitor.
Further reading can be found at the following links:

• Tommy’s https://www.tommys.org/pregnancy-information/im-pregnant/illegal-or-recreational-drugs-and-pregnancy
• NHS https://www.nhs.uk/pregnancy/keeping-well/illegal-drugs/

The Neonatal Outreach Team, NICU, Norfolk and Norwich University Hospitals provide a few further tips to help babies that NAS:

• Provide a quiet environment with dimmed lighting.
• Handle the baby very gently to help reduce irritability.
• Gentle baby massage and bathing can be soothing.
• Keep them cool and change them frequently if they are sweating (avoid them getting too hot).
• Feed them regularly small feeds are usually best.
• Dummies can be helpful to settle the baby if he/she is excessively sucking.
• Keep the baby’s nose clean gently wiping it.
• Change the baby’s bum regularly. the baby’s bottom may get sore due to loose stools/diarrhoea. Creams are helpful to protect the skin.

Infectious Disease

When the baby is born a series of tests are carried out to confirm if the baby has any blood-born diseases such as HIV and hepatitis etc.

These should be noted on the medical discharge form. If you are not able to obtain a copy of this document, then ask the CSW if they can check and confirm that you are not at any additional risk.

Close attention should be given to personal hygiene if you are not sure if the baby has any infectious disease, this is not saying do not cuddle the baby or have contact with them, it is to ensure you do not contract any infection from blood or bodily fluids from the baby or breast milk from the mother.

As a foster carer fostering babies, you should seek additional training from the IFA/LA on how to keep safe when handling infectious material.
Additional reading can be found on the NHS website here. https://www.gov.uk/government/publications/screening-tests-for-you-and-your-baby/infectious-diseases

Feeding tubes and other special care arrangements

You will be on occasion asked to care for a child with various medical complications, these can be from babies being fed by a feeding tube to babies who have no adrenaline. All are specialist tasks carried out by foster carers, if you are unsure of what to do then do not hesitate to seek assistance and appropriate training in how to do the procedures from the Midwives, Health Visitors, and Hospital Neonatal unit.

Registering a child with a General Practitioner (GP)

The baby will need to register with a doctor given the rights of the birth parents, the easiest way is for the birth parents to register the baby. If this is too slow in happening (Remember you have first initial jabs at 8 weeks), then talk to the CSW about registering them or if you can arrange to register the baby yourself.

Ask the surgery what documentation is needed, normally a copy of the birth certificate, the red book and a copy of the placement plan will be sufficient, however, this varies from surgery to surgery. Please note you might not always have a copy of the birth certificate, or the baby might not even be registered, in this situation, the CSW should register the baby’s birth.

DNA Testing

DNA testing is carried out when the perennity is in doubt. It is a quick and painless procedure for babies and most babies sleep through it or can be quickly comforted with a bottle. The procedure is normally carried out in the home and normally involves a small prick to the heel or a cheek swab.

Medical Care – Inoculations/ Immunisation

This is normal for all babies to have inoculations for DTaP/IPV/Hib/HepB vaccine at the 8-week, 12-week, and 16-week terms. The DTaP/IPV/Hib/HepB vaccine protects against 6 different diseases – diphtheria, tetanus, pertussis (whooping cough), polio, Haemophilus influenzae type b and hepatitis B.

You will also need to ensure the child should have a Hib booster (in combination with MenC) at 1 year of age.

See further information on Immunisation vaccines from the NHS website. https://www.gov.uk/government/publications/a-guide-to-immunisations-for-babies-up-to-13-months-of-age/a-guide-to-immunisations-for-babies-born-on-or-after-1-january-2020#:~:text=Your%20baby%20should%20be%20immunised,type%20b%20and%20hepatitis%20B

Do not be surprised if the baby cries through these, side effects can be a spike in temperature, and horrible nappies for a few days after depending on the inoculation given.

Midwives & Health Visitors

Normally the Midwives will hand over to the Health Visitors when the baby reaches its birth weight, no complications are evident (Jaundice etc…), and the baby is eating sleeping and defecating as normally, usually, this is within 10 days.

Health visitors normally have set geographical areas to cover and it is always preferred to have the same Health Visitor throughout the baby’s development which helps build up a rapport to obtain the best outcome for the child. If you have more than one child then you a likely to be assigned the same Health Visitor for both children.

Fostering Babies that are Premature

Some babies are born premature and kept in the neo-natal units after birth. You will be required to see and spend time with the baby whilst they are there. Sometimes you might be their only visitor other times you might have to avoid parents and have to wait inside rooms until they have left.

To be fair you will normally find Midwives set visiting times for you and the birth parents. The babies are normally on the unit until they are strong enough to leave this will include feeding and defecating as normal. They may be initially tube-fed – where possible they will not be discharged until the baby is feeding without tube assistance.

Later years

You might take a baby on from birth, however, with the courts and social service being overwhelmed and many other reasons, the baby’s journey can be slow to either reunite them with the birth families or move on to adoption.

You might have a child with you long term. If this happens you will be in a strong position to put things in place for the later years of the child’s life like starting nursery, EHCP, DLA etc…

You can get additional funding for different things so check out FosterWiki’s pages on funding and education to see what could be available as well as talk to your supervising social worker/link worker.

Memory Boxes

The memory box is a useful way to collect important information about the early years of the baby, you will get the first toys, hospital bracelets, and umbilical cord clips. First lock of hair, family photos and items from birthdays and birth family.

“We have A4 memory boxes that have the child’s name and date of birth engraved on the top. Although at first, we used to put the last name on as well as the first it can be confusing when a child’s last name changes multiple times throughout their stay”

Contact with Birth Families

Contact is an important part of looking after babies. It will depend on the resources the LA/IFA have if contact services can be utilised and what the CSW recommends to the court.

You could be asked to support the provision of contact up to 5 days a week, 3-hour sessions. Although this was dramatically reduced during the lockdown and in some cases it could be down to twice a week for 1-hour sessions.

Contact requirements change depending on providers, in some instances, it is the foster carer’s job, while others tend to take the view foster carers might not always be available to do contact as they have other children or commitments.

It is not uncommon for birth parents to disengage and not turn up to contact sessions, even if they are requested to confirm on the day, do not be surprised if the baby is returned to you early.

Always provide the contact worker with a contact bag. Ensure they have a spare set of clean clothes, bibs, nappies, Infacol if used, nappy sacks, nappy cream, a bottle with food, blankets, a contact book etc. Failure to provide any of these could mean you will get a complaint made against you; this is not uncommon as you are an easy target for them venting frustration with the system.

The contact book should be used for every contact session, and let the parents know of upcoming medical appointments (Birth parents usually have the right to attend all appointments and it can cause issues further down the line in court if they are excluded from these.), how much they weigh and their progress when they have seen the health visitor. Use it to ask questions if needed and let the parents know how the baby has been sleeping etc… Also note when they had their last feed and nappy change.

Birth Parents are encouraged to ask questions so don’t forget to read the book when contact is over.

It is good practice as mentioned before to try and send the baby to contact in clothing provided by the parents.

You might be asked by an independent social worker to provide wash and bath items or feeding items including washing up and sterilisation equipment (They might also ask for dirty bottles), this is so the parents can be assessed, and the contact session might also be an extended period.

Please see our FosterWiki pages for further information on contact time.

• Top 10 Tips for Contact and Family Time https://fosterwiki.com/wiki/top-10-tips-for-contact-and-family-time/
• What is Contact? https://fosterwiki.com/wiki/what-is-contact/

Protecting yourself from allegations

From time-to-time babies will scratch themselves, this is not uncommon, however, babies might come back from contact or respite with marks on them, you need to be aware of any marks on the child and make detailed notes including a body map for any injuries noticed.

It is always preferable to have photographic evidence, however, you need to keep in mind that private areas are not photographed. Body mapping is a good alternative.

Record any evidence of physical abuse that is visible on the child’s body on a body map using a key to identify where and what the injury is, e.g., 10p size bruise on the inner side of the top arm, details of the circumstances of the disclosure and whether anyone else was present when the disclosure was made / injury was noticed.

Information should be signed and dated and ALWAYS written in pen so that it cannot be amended or removed later.

Most organisations will have body maps and procedures that dictate how written reports should be made, check with your Local Authority or Fostering Agency to see if they provide these and keep a spare copy as a template.

Inform your SSW and the CSW if any injuries are identified and seek medical attention if needed.

Please see below for an example of a body map for infants.

What Carers Say