The opioid crisis is placing more infants into foster care leading to further strain on foster care agencies and greater calls for foster parents. Dreaming of Baby speaks with Dr. John DeGarmo, director of the Foster Care Institute and international expert and consultant on foster care and child welfare. Dr. DeGarmo speaks with Dreaming of Baby about the opioid addiction crisis, the effects of opioid addiction in pregnancy, and the challenges – and rewards – of fostering a child with opioid withdrawal.

Daniela GS: Dr. John DeGarmo is an International foster care expert and consultant. John is himself a parent of biological, adoptive and foster children, as well as having experienced first-hand the effect of opioids on children. Welcome to Dreaming of Baby John, we’re looking forward to discussing the reality of opioid addiction on pregnancy as well as what this leads to further down the line.

Dr. John DeGarmo, Ed.D.: Thank you for the opportunity! To be sure, this is an important topic, yet one that is ignored and often overlooked by society.

Neonatal Abstinence Syndrome

Daniela GS: How grave an issue is opioid addiction in reality? How many babies are being born with neonatal abstinence syndrome?

Dr. John DeGarmo, Ed.D.: Oh my. In all seriousness, the opioid addiction problem is actually at a crisis level in the United States. Last year, 33,000 people died due to opioid addictions. Sadly, many of those mothers addicted to opioids are giving birth to children who are affected. While we do not have statistics on how many babies are born addicted and suffer from NAS, we do know that up to 94 percent of babies born to mothers who used opioids while pregnant will suffer symptoms of drug withdrawal

Dr. John DeGarmo, Ed.D.: Furthermore, out of every 1,000 babies born in many opioid affected states, at least 30 are born with NAS. Another study found that babies born the past decade suffering from NAS increased five-fold across the nation.

Daniela GS: The way you describe it, the situation really is at crisis level. Can you tell us a little more about your experience with babies suffering from opiate withdrawal?

Dr. John DeGarmo, Ed.D.: Well, as one who has cared for over 50 children in my own home as a foster parent the past 15 years, I have had several babies come into my own home, suffering from various symptoms of NAS. Indeed, the three I have adopted from the foster care system were all born to mothers who were taking opioids during pregnancy. All three suffered from withdrawals, and seizures, and now all three struggle with unique challenges due to their mother’s past addictions.

Fostering Babies with Opiate Withdrawal

Daniela GS: What led you to foster babies with opiate withdrawal?

Dr. John DeGarmo, Ed.D.: In the United States, on any given day, there are roughly 500,000 children in foster care. The numbers are up the past few years, due mainly to the opioid crisis. Yet, with more children in care, there are not enough parents. My family and I have had up to 11 children in our home at one time, and even had 7 in diapers at one point as there are not enough homes, not enough families willing to help. We have had children as young as 27 hours old in our home, born suffering from NAS. We dot, we foster these babies simply because the need is so strong. Someone has to care for these babies. Someone has to give them support, stability, and love. Make no mistake, it is not easy. Most challenging thing I have done. Yet, it has been the most rewarding thing at the same time.

Daniela GS: I can only imagine. Based on this experience, what advice would you give moms who are currently caring for babies with NAS?

Dr. John DeGarmo, Ed.D.: Patience. Incredible patience. These babies are filled with pain, with anxieties, and are suffering. They show this pain and suffering through seizures, and through screaming. It is during this time that one can truly not comfort a baby with NAS. As the drugs in the baby’s system slowly wean out of the body, and out of the system, the baby is in pain. This pain is released through constant screaming. I have held babies in my arms who have screamed in pain for weeks on end, and in some cases, for several months. It is almost 24 hours of screaming, with little sleep for the baby. Truly heart-breaking on several levels. Those mothers who care for these babies not only need patience, they need support, as it is, sadly, very exhausting, and can be overwhelming at times.

Daniela GS: In this regard, do you think the support system available for expectant mothers with opioid addiction, and eventually for them to be able to care for their newborns, sufficient enough?

Dr. John DeGarmo, Ed.D.: Not at all. Not at all. Many times, these babies, and these mothers are released from the hospital with little support, with little resources, and with little training to care for these babies. Along with that, they are often struggling with their own addictions, and struggling to help themselves. Thus, many of these babies are placed into a foster care system that is also struggling to keep up with the higher number of children being placed into it.

Daniela GS: It sounds like the situation revolves in a vicious circle. Is there no place where these moms can find some support though? Apart from foster care, what would the options be for care, for both mothers and babies?

Dr. John DeGarmo, Ed.D.: Yes, a vicious circle, to be sure. Two of the three children I have adopted are third generation foster care, as well as generational drug addiction. These mothers can find support with local faith based organizations, and faith based non-profits in their area. Along with that, many hospitals can help provide information, and sometimes even training. Finally, local and state child welfare agencies also often have resources and training available for these mothers. As for another option, there is often the option of kinship care. Kinship care is when a relative (grandparent, aunt/uncle, older sibling) cares for the baby as the mother seeks help and treatment.

Daniela GS: This insight will prove very helpful for someone who is struggling; it helps to be aware of the options available and where support can be sought. You noted earlier that symptoms of drug withdrawal last through the years, even when these babies are all grown up. What kind of symptoms are most common in such cases?

Dr. John DeGarmo, Ed.D.: withdrawal symptoms can take the form of seizures, elevated heart and respiratory rate, difficulty in sleeping and eating, and extreme bouts of irritability, and even problems in growth development. These lead later on in life with difficulty in school, difficulty with focusing upon any one thing for a period of time, and challenges with Math and Reading skills. There is also the challenge of developing addictive qualities, which can lead to drug abuse for the child later on. These are a few of the symptoms.

Daniela GS: For those persons taking the path to parenthood via adoption, does adopting an infant with NAS differ from the usual adoption procedures?

Dr. John DeGarmo, Ed.D.: It does not in a legal sense. NAS simply makes it different in a parenting sense, as it is challenging, to be sure.

Daniela GS: Opioid use in pregnancy is indeed a very serious situation. As someone who has experienced first-hand the struggles of children suffering from withdrawal symptoms; what would be one piece of encouragement that you would give parents and / or foster carers?

Dr. John DeGarmo, Ed.D.: Every child, every baby deserves to be loved. Every baby needs it to develop. With consistency, with patience, with support, and with a supportive, safe, stable and loving environment and home, the life of a baby can be changed. There is, make no mistake, hope.

Daniela GS: Thank you for that. You have provided insight that many will find very helpful; being aware of the situation is so important. I am sure that your encouragement will also assist many in their journey. Thank you for your time today and for sharing your experience with Dreaming of Baby! It’s been a pleasure.

Dr. John DeGarmo, Ed.D.: Thank YOU for the opportunity, and thank you for bringing awareness to this important issue. Awareness equals advocacy.