September 01, 2011

Infants in Foster Care: Trends and Tips

Claire Chiamulera

The views expressed herein have not been approved by the House of Delegates or the Board of Governors of the American Bar Association, and accordingly, should not be construed as representing the policy of the American Bar Association.

Research is uncovering new information about how infants who enter foster care differ from their older counterparts. The findings help shape advocacy for these children. They stress the need to identify their needs and promote positive outcomes for them.

Researchers at Chapin Hall at the examined five areas in which infants in foster care differ from older children. Highlights from their findings in each area appear below.

Out-of-home placements

Infants are entering care at disproportionately higher rates than older children.

The researchers analyzed data from the Multistate Foster Care Data Archive, which tracks admissions into care, placements, permanency outcomes and returns to care. They reviewed data from 14 states in regions throughout the country between the years 2000 and 2008.

The analysis revealed that:

  • In 2000, the risk of placements for infants was four times greater than for older children and that percentage rose in 2008 (7.6 per 1000 in 2000 compared to 8.9 per 1000 in 2008).
  • In 2008, 22% of children entering foster care for the first time were infants.
  • From 2000 to 2008, the number of infants entering foster care increased 19%.
  • Infants represented 24% of first-time admissions in urban areas (largest county in each state).
  • Fewer children entered care in rural counties but their numbers are growing, with 14% entering care in 2000 compared to 19% in 2008.

Time in care

Infants spend the longest time in care. Again using data from the Multistate Foster Care Data Archive, the researchers found two patterns:

Longer stays. Infants entering care before three months of age spend 33% more time in care than children entering care who are age 3-12 months. Also, the youngest children spend 50% more time in care than older children. These findings may be partly explained by the higher adoption rates of young infants, requiring more time in care while efforts are made to rule out reunification and complete the adoption process.

Mean Time in Care. Between 2000 and 2008, the mean length of time that children under age three months old spent in care declined by two months. However, it increased slightly during this time period for infants who entered care at age 3-12 months.

Experiences in care

Based on the analysis of the data from the Multistate Foster Care Data Archive, the researchers uncovered some differences in the way infants experience care. These include:

  • Group care. Less than 6% of infants spend more than 50% of their time in group care settings. Those that do are often in medical settings. This compares to older children who are more likely to be placed in group care, although the researchers noted a decline in group care placements for older children from 2000 to 2008.
  • Foster care. Infants are far more likely to be placed in foster care placements than older children. In 2000 and 2008, over 60% of infants spent most of their time in foster care placements compared to 44-50% for older children.
  • Kinship care. Infants increasingly are being placed with relatives due to the growing emphasis on placement with relatives to maintain family ties. In 2000, 20% of infants were in kinship placements and that percentage grew in 2008 to over one-third of infants. Older children were also found to be equally likely to spend much of their time in kinship care.


To understand characteristics of infants who enter care, the researchers reviewed data from the National Survey of Child and Adolescent Well-Being, which surveyed over 5,500 children age 0-14 nationwide who had be investigated for child maltreatment over a 15-month period. This review revealed the following characteristics about the infants and their families and caregivers:

  • Race. 39% of infants are African American, while older children are more likely to be white (48%).
  • Gender. A majority of infants and older children entering care are female (53%).
  • Maltreatment. 46% of infants entering care experienced neglect, including failure to provide, being subject to unsanitary conditions, and prenatal drug exposure.
  • Health. Infants entering care had more health problems than older children; 19% had fair or poor health and 28% suffered from a chronic illness. In comparison, 10% of older children were in fair/poor health, while 14% had a chronic illness.
  • Health insurance. Infants are more likely to have health insurance through Medicaid or a state program (95%) compared to 79% of older children.
  • Birth families. 65% of infants’ birth families had been involved with the child welfare system previously, with drug/alcohol use and domestic violence common underlying problems. 41% of infants’ primary caregivers had been recently arrested, compared to 24% of older children’s caregivers. Caseworkers also reported high levels of family stress in families of infants (79%). Financial stress was a factor for 57% of infants families compared to 39% of older children’s families.
  • Caregiver mental health. 42% of infants’ primary caregivers had a serious mental health or emotional problem, compared to 28% of older children’s primary caregivers. Intellectual/cognitive impairments were also higher for infants’ caregivers (15% compared to 9% for older children’s caregivers).

Vulnerability for delayed development

The researchers observed that the toxic stress that infants in care experience early in their lives affects their development in several domains: emotions, behavior, cognitive functioning, and health. Neglect, abuse and trauma, combined with caregiver transitions, create considerable stress for infants that they have difficulty regulating. The result is often delayed development and slowed physical growth (sometimes leading to failure to thrive).

Practice Tips

Advocates who understand the unique characteristics and experiences of infants who enter the child welfare system can better support efforts to intervene on their behalf. Three critical advocacy steps identified by the researchers include:

  • Screening and early intervention to identify infants’ developmental issues early so that supportive interventions can be put in place.
  • Support to parents, foster parents, or other caregivers to help them provide nurturing, supportive environments that promote infants’ recoveries from early trauma and negative events.
  • Proper therapeutic techniques aligned to the child’s developmental needs to help infants heal and promote their developmental progress.


Related resources:

Healthy Beginnings, Healthy Futures: A Judge’s Guide

ABA Health of Infants, Toddlers and Preschoolers Project