For most people, the word orphanage conjures cold Dickensian images of cruelty to children -- and yet whenever I write that children under five should never be kept in institutional care, I hear from people who vigorously defend such facilities.
With public attention focused on the horrifying case of Artyom Savelyev who was sent home alone to Russia after being briefly adopted from an orphanage, more people need to know why orphanages for infants are indefensible and can safely and economically be shuttered.
Indeed, that has already quietly happened in the U.S. and Western Europe over the last few decades. Baby orphanages here have gone extinct because experts now understand the profound dangers they pose for infants. But to help more kids and future adoptive families, these facilities for infants need to be abolished in the rest of the world as well.
Unfortunately, the myth of the good orphanage for little ones lives on in the popular imagination and in Eastern Europe and China. Even the New York Times recently promoted it, with an article that claimed that research shows orphanages are fine for kids. Sadly, the article failed to note that the research was conducted on children over six-- and so doesn't apply to orphanages for babies.
More recently, in an editorial on the Savelyev case, the Times said that Russia's orphanages were merely "overcrowded, with too few staff members and resources." Instead, it should have called for replacing baby orphanages entirely with foster care.
Here's why. As we discuss in our book, Born for Love: Why Empathy Is Essential -- and Endangered, about 1/3 of babies placed in the barest orphanages can actually die as a result (one very early study found this death rate).
Half of the rest -- at least double the rate seen in the general population -- will suffer from mental illness. Each month spent in an orphanage in early life reduces IQ and increases risk of behavioral and psychological problems--and this has been proved by the highest level of scientific proof we have, a randomized controlled trial.
But how could simply being in an orphanage kill a baby? Basically, they die from lack of love. When an infant falls below the threshold of physical affection needed to stimulate the production of growth hormone and the immune system, his body starts shutting down.
Research suggests a physiological pathway that produces this effect, which was first understood as "runt syndrome" in mammals. In litters of puppies and kittens -- even in rats and mice -- oftentimes one or two animals are significantly smaller than the rest.
The weakness exhibited by these animals signals the mother that they have little chance of survival. To make sure her genes live on, she would be better off using her limited resources to make sure that the rest of litter stays healthy.
The signaling works like this: in some species, each baby has a "preferred" nipple. The weak ones don't suck strongly enough to stimulate that nipple sufficiently. Consequently, the mother does not lick or nurture the baby that uses that nipple very much. In other species, the weak animals simply don't get access to the nipple and the mother then ignores them.
Unfortunately for the runts, a certain level of maternal licking and nuzzling is necessary to turn on the production of growth hormone in the brain. Without growth hormone, food isn't metabolized properly and growth and development do not progress. Barring intervention, the runt will "fail to thrive" and essentially, wither and die.
In humans, the immune system seems to be profoundly affected, making these children especially vulnerable to all types of disease -- probably because not being nurtured is extremely stressful and high levels of stress hormones can turn off the immune system. (That's why corticosteroids-- essentially stress hormones -- are often used to treat auto-immune diseases where too much immune response is the problem).
In fact, "failure to thrive" in human infants has been shown to result from lack of individualized, nurturing, physically affectionate parental care, whether in an orphanage or due to extreme parental neglect. Babies' brains expect that they will experience nearly constant physical touch, rocking and cuddling: without it, they just don't grow. And without receiving kind empathetic care, they are less likely to behave that way towards others as they get older.
Orphanages simply cannot provide the levels of intensive individual care that infants need to generate enough growth hormone and empathy. Incidentally, this is why babies raised in orphanages are almost always physically smaller and have smaller heads and brains than those raised with even not-so-great parents.
Moreover, that's just part of the physiology that we understand. When a baby is not the center of someone's world, he or she misses out on many other types of stimulation and experience as well. No one has yet documented how this affects other brain and body systems but we know that the stress system affects virtually every cell in the body. The emotional and behavioral problems that often frustrate adoptive parents and the children themselves are mostly preventable. Though these children can be remarkably resilient if they later receive intense affection, there is no doubt that the experience of orphanage life is painful and damaging.
So why do baby orphanages still exist? It's not cost -- foster care is actually at least six times cheaper than keeping a baby in an institution, according to research [pdf].
The problem is cultural beliefs that orphanages aren't harmful and funding streams that preferentially provide money to institutions, not individual families. The only way to fight this is to raise awareness of the issue and prod governments and funding agencies to provide humane, family-based care to all children. Baby orphanages are harmful and there is no legitimate justification for their continued existence.
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you said. Everything.
I have slightly different theories on some of it, but I believe my theories are
insignificant compared to your intent.
I think this may be, on many levels in the human psyche, one of the most
important articles I've ever read on Huffington Post. You cover more ground
than most will realize.
Any suggestions on who to write in other countries about this?
Though you write in the international context, the issue often arises in this country – usually whenever there is a scandal in foster care. Indeed, it’s the topic of two of the most recent posts to the NCCPR Child Welfare Blog: http://bit.ly/bhv8Wt And in this country, foster care vs. orphanages is the ultimate lose-lose proposition.
As you know, Many children in this country are placed in substitute care when family poverty is confused with “neglect” – the idea that it would make more sense to help families with the financial resources to raise their own children is not limited to Africa. Get these children and others who could safely be in their own homes out of substitute care altogether and there would be plenty of room in good, safe foster homes for those who really need to be taken away – and no one would even *think* of bringing back the orphanage.
Richard Wexler
Executive Director
National Coalition for Child Protection Reform
www.nccpr.org
A foster care placement starts not with the child but the belief that a woman or family can give back by helping these children. Many times they can, twenty percent or a larger percentage, by the time they are removed from the foster home or adopted home have harmed the children in the home, destroyed the marriage and the foster adoptive parents are blamed for not changing the child. An impossibility because of the damage that had occurred before they took him/her.
I understand why she sent the child back to Russia. Until you live the horrors these children can do to you, even with your degrees and years of training, you can not understand what happens to the family, both parents and children and that there should be a place to sent these mentally deficient and morally empty children.
That's not to say that it isn't traumatic for a 3-year-old, say, to go from a loving foster home to new parents-- but it's a very different thing than for a child who has never known a parent's love to suddenly be placed in a family. Losing one's parents is, sadly, an evolutionarily common experience that the brain is at least built to cope with. Never having parents during infancy isn't.
This case was especially awful in terms of a Russian adoption in that the child was taken away from the bio mother due to neglect and/or abuse and *then* spent time in an orphanage. And the child also had fetal alcohol syndrome. That's one of the worst case scenarios and could well lead to disaster. I'm not arguing that this couldn't result in a child who required some form of inpatient help-- and I'm not arguing against such places (heavily regulated, well-staffed with highly trained people). However, the adoptive mother in this case never even took the child to a psychologist or psychiatrist-- suggesting very clearly that the child was far from the only one with a problem here.
What I am arguing is that if you never put babies into orphanages, you'd have far fewer later adoption failures.
It's certainly not the case that foster parents kill at a rate anywhere near the rate that bad orphanages can-- if one in three foster care kids were dying or even one in 20, it would be a major media scandal. The model itself is flawed for infants and not ideal for older kids either-- but at least for the older kids, it's not potentially deadly and brain-destroying.