We are Family

this was originally posted on February 25, 2009.

Attachment and adapation are big words in the adoption world.  You want your new family member to smoothly adapt to the transition and attach to his/her new family members, and those things don’t happen by accident.  We have an adoption medicine specialist for our pediatrician and he offered us great tips to help the transition home.  I also recently ran across really great language to try and explain this period of transition to others (I ran across this phrase on a blog but I can’t remember where I found it. If you know it, let me know as I’d love to link to it).  The children we adopt will have their chronological age.  They will have their developmental age.  But they will also have another age– their family age which means how long they have been in your family.  Responding to your child in a way that meets them where they are with their family age will infinitely help them with attachment and transition.  So what does that exactly mean?  When we came home with our baby, he had only been in our family one week.  Given that, it would have been inappropriate to let him ”cry it out” when he was inconsolable as we’d never let our one week old newborn cry it out.  Instead, he needs us to soothe and comfort him and show him that we are dependable as parents.  The same would have been true if we brought a three year old home or a six year or you get the picture.  The advice with considering family age is that how long your child has been in your family is a better way to determine what your reaction should be over how old a child is.  When I can’t help people understand the nuances of attachment, adaption, and transition in our adoption with my original explanation, I have now found that explaining about family age and how it applies to us and what age our baby is in our family greatly helps (as we get lots of ‘let him cry it out or he’ll be spoiled’ advice about his lack of sleep when we know that his lack of sleep is a result of many, many transition issues that will just take a little bit of time to tackle).  Anyway, here are the instructions we received from our pediatrician– most of which are specific to our situation but can be generalized for your’s.  I hope you’ll share what you are doing, too, as we can all learn so much from each other!

Instructions from our pediatrician:

Buy the formula he was fed in Ethiopia and bring home 4-7 days worth of it and slowly transition to a formula found here.

Feed him his formula on demand.  Wait until we’re home and through the well visit to start a food plan that we determine with our doctor.

Do not schedule the well child comprehensive visit for immediately when we get home.  Instead, schedule it for 2-3 weeks after we’re home so that we have soothing techniques and trust with him established.  At that doctor’s appointment, expect a significant blood draw (it ended up being 8 vials of blood) for screening labs to test for multiple illnesses and general health indicators like thyroid function, lead, complete blood count, a comprehensive metabolic panel, etc, a skin test for TB, to leave with tubes for stool tests, consults for audiology and ophthmalogy screenings and catch-up vaccine discussion and planning.

The longer we can be at home with him, the better.  To this end, we did everything we could to have as much of our work for February done in January before we left (I turned in six articles due in February the week before we left town) so that we could not have to wind up back to work activities immediately when we got back.

Be aware of overstimulation, and be proactive in preventing situations that will be overstimulating in some way.

Set a clear expectation with others early on that allows them to understand that parenting a child who is adopted requires nuances of care that are different from what another’s experience may have been if he/she did not have adopted children.

Do not have a welcoming party at the airport.

Eliminate overnight traveling and get togethers for the first several months.  Large groups should be avoided for 3-4 months.

As parents, embrace and be responsible for all of his care.  We are the only two who should feed, diaper, comfort, bathe, and put Abram to bed for at least 4 months.

Put off babysitting.  In our case (given our work situation and the age of our child), he suggested 6 months of one of us being with him at all times.

Have a period of time where only the three of us are together and then slowly allow visitors.  In our case, we had one week of just the three of us in the house and then had family members stop by in groups of 2 the next weekend.  We still haven’t done the big stimulating things like go to Target with the baby (when we have gone to Babies R Us for formula, one of us has run in while the other one of us waited in the car with baby).  Our daily adventures are limited to walks in the stroller.

Establish and follow a routine that works for us as a family and fit other things around it.  A routine will help him in his transition.

Spend a significant amount of time on the floor playing with him (facing him).  Specifically, our doctor recommended that we each do at least 30 minutes of floor time with him a day for at least 3 months but possibly up to six months.

Talk to him all of the time, explaining what we are doing (even if it is cutting vegetables for a salad), showing him words as we engage him.

Each parent should hold him for at least an hour a day (again for at least three months but possibly up to six months).

Don’t let him cry it out.  He needs to know that we are there for them and can soothe him.

Make lots of eye contact, especially during feedings.  Always feed him, even if he wants to feed himself– make sure our hands are on the bottle, too.