Foster Care

Overview

Foster care is a way of looking after children who cannot live safely with their own family for a while. The child goes to live with a foster carer — an adult or family who has been trained and checked to look after someone else's child — while the children's services team at the local council or government stays involved. Foster care is usually meant to be temporary. Some children go home after a few weeks or months. Others stay longer, move to live with relatives (this is called kinship care), or go on to be adopted. Foster carers do the day-to-day parenting, but they are not the child's legal parents, and big decisions are shared with the child's social worker and the courts.

Yes. Every country uses foster care and kinship care, and large numbers of children around the world live with foster families at any one time. It is more common than many people realise — most of us know someone who has been in care, even if it is not talked about openly.

Children and young people from birth up to 18 years old, and sometimes beyond 18 if they stay with a foster family while finishing school or training. It also affects birth parents and relatives, foster carers and their own children, and the professionals who support them. Children with disabilities, siblings who need to stay together, and young people who arrive in a new country alone are all part of this group.

Symptoms

Common symptoms

• Finding it hard to settle, relax or sleep in a new home
• Big feelings — anger, sadness or fear — that seem out of proportion to what is happening
• Being very watchful and 'on guard', or the opposite: being extremely keen to please
• Struggling at school, refusing to go, or finding it hard to concentrate
• Going back to younger behaviour, such as bedwetting or thumb-sucking, after the child had grown out of it
• Keeping belongings close, hiding food, or not liking changes to routine — signs of past uncertainty
• Feeling torn about contact with birth family: longing to see them and feeling upset afterwards
• Headaches, tummy aches and other physical complaints that get worse at stressful times

Symptoms in children

• Clinginess, tantrums or 'meltdowns' that are more intense than expected for the child's age
• Sleep problems, nightmares, or wanting a light on and someone nearby at bedtime
• Problems with talking, listening or understanding, which may have been missed before
• Delayed development in movement, speech or self-care skills
• Not wanting to eat, overeating, or hoarding food
• Being unusually quiet and 'good', or unusually rough with other children
• Toilet accidents during the day or night
• Sore teeth, tummy troubles or missed immunisations found at a health check

Symptoms in older adults

• Foster care is mainly about children, but the adults around them can struggle too — it is worth knowing the signs
• Foster carers feeling exhausted, isolated or guilty for finding it hard
• Birth parents feeling deep shame, grief or anger, and avoiding appointments
• Grandparents or other relatives suddenly raising a child (kinship care) with little warning or money
• Low mood, anxiety, poor sleep or heavy drinking in carers who are not getting support
• Carers neglecting their own health checks, dental care or medication reviews

Causes

Main causes

• Abuse or neglect at home, including physical, emotional or sexual harm
• A parent being too unwell to care for a child, for example with serious mental illness or a stay in hospital
• A parent misusing alcohol or drugs
• Domestic abuse within the family
• Family breakdown, bereavement, or a parent dying
• Housing crisis, homelessness or destitution
• A child arriving in a new country without a parent or carer
• Sometimes a child's own behaviour or disability puts huge strain on a family that has no support

Risk factors

• Family poverty and money worries
• Parents who have no support network and no one to ask for help
• Parents who were themselves in care or had a difficult childhood
• A parent with a disability or long-term illness
• Very young parents, or parents with several children close in age
• A child with a disability or complex health needs
• Frequent moves and housing instability
• Lack of early help — support that arrives too late or not at all

When to see a doctor

See a doctor urgently if:

• A child has an injury that is not explained, or looks older than the story suggests
• A child discloses harm or abuse — get help the same day
• Thoughts of self-harm or suicide, or a young person saying they do not want to be here
• A child stops eating or drinking, or is losing weight quickly
• A child has been missing from home, or is being pressured or exploited by others
• A child is extremely distressed and cannot be calmed, or is not sleeping at all
• A fever, infection or tooth problem that is getting worse

Book a routine appointment if:

• The first health check after a child comes into care — usually within the first few weeks
• Regular health reviews while a child is in care
• Any worry about mood, behaviour, sleep or school, even if it seems small
• Missed or overdue immunisations, dental checks, hearing or vision tests
• Questions about development, speech or learning
• Support for foster carers, birth parents or siblings who are struggling
• Advice about a young person moving towards independent living

Diagnosis

Foster care is a situation, not an illness, so there is no test for it. What doctors and nurses do is check how the child is doing. In the UK, every child who comes into care is offered an initial health assessment, usually within the first few weeks, followed by regular reviews. A nurse or doctor will talk with the child (at their level), the foster carer and the social worker, review the child's records, and look at physical health, growth, development, emotional wellbeing, teeth and immunisations. The child can be seen alone for part of the appointment if they want to be.

Tests that may be done

• Height, weight and growth checks plotted on a growth chart
• Hearing and vision checks
• A dental check and a look at the teeth and gums
• A review of all previous immunisations and any missed ones
• A developmental review for babies and young children
• A mental health and wellbeing questionnaire, often done with the child and carer
• Speech, language and communication checks if there are concerns
• Blood tests, urine tests or a referral to a specialist only if something specific is found

What to expect at your appointment

The first appointment is mostly a conversation, not an examination. You will be asked about the child's history, health, sleep, eating and school. Nothing is done without explaining it first, and older children can be seen on their own. You will be told what happens next and who to contact with worries. If something is found — a tooth problem, a missed jab, a worry about mood or learning — a clear plan should be made and shared with the carer and social worker.

Treatment

There is no medical treatment for being in foster care. What helps most is stability: a safe, predictable home, adults who keep their word, keeping siblings together where possible, staying at the same school, and quick access to the right support when problems appear. Health professionals focus on catching problems early — health, development, teeth, hearing, vision, learning and emotional wellbeing — and getting the child help before small worries become big ones.

Self-care at home

• Keep a simple health record — appointments, immunisations, allergies, medicines — and pass it on if the child moves
• Keep routines steady: regular meals, bath and bedtime, and the same person doing the school run
• Explain what is happening in honest, age-appropriate words, and answer questions more than once if needed
• Listen without needing to fix everything straight away
• Keep every health, dental and school appointment, even the ones that feel routine
• Help the child stay in touch with brothers, sisters and other important people, where it is safe to do so
• Say sorry and repair things when a day goes badly — this teaches trust
• Ask for help early: from the social worker, the school, the health visitor or the looked-after children's nurse

Medical treatments

Support is usually a mix of talking therapies (such as counselling or trauma-focused therapy), child and adolescent mental health services, speech and language therapy, occupational therapy, educational support, and treatment for any physical problem found at a health check. For specific conditions such as depression, anxiety or attention problems, a full assessment is done first, and any medicine is discussed carefully with the young person, their carer and the clinical team. Foster care itself is never treated with medicine.

When is surgery considered?

Surgery is not relevant to foster care itself. A child in foster care might need an operation for an unrelated health problem, just like any other child. In that case the foster carer, social worker and hospital team work together on consent, planning and recovery, and the child's views are taken into account.

Living with this condition

Day-to-day life in foster care works best when it is boring in the good way: the same breakfast, the same route to school, the same bedtime story. Change is unsettling, so when something has to change — a new school, a contact visit, a review meeting — explain it early and calmly. Keep a calendar the child can see. Keep one trusted adult steady across moves if you can. And make room for fun: play, sport, drawing, pets, cooking together. Fun is how trust is built.

Lifestyle tips

• Stick to predictable daily routines, especially around meals, bedtime and school
• Keep the child's belongings together and safe — a simple box or bag of their own matters
• Limit late-night screens and keep bedtime calm and consistent
• Encourage friendships and out-of-school activities; these build confidence and belonging
• Keep contact with siblings and important people where it is safe
• Stay in touch with the school and tell them what is going on at home
• Make time for the foster carer's own rest and support — a tired carer cannot give steady care

Diet and exercise

Ordinary healthy living helps a lot. Offer regular meals and snacks at set times, plenty of vegetables and fruit, and water instead of sweet drinks. Some children who have known hunger may hoard or overeat food at first; it usually settles when they learn food will always be there, so try to respond calmly rather than restricting. Aim for about an hour of moving about each day — walking to school, football, dancing, cycling, swimming. Exercise is also a great outlet for big feelings. If eating or sleeping worries you, mention it at the next health check.

Mental health and emotional wellbeing

Many children in foster care have been through frightening or confusing experiences, and their behaviour is often a signal of distress rather than naughtiness. Anxiety, low mood, sleep problems, being 'on guard', and difficulty trusting adults are common. This can affect how it works out for the child, so if you are worried about mood, self-harm or suicidal thoughts, tell someone today rather than waiting. It is okay to ask for help more than once. Talking therapies can make a real difference, and most children do gradually feel safer and calmer with time and consistency.

Prevention

Foster care is not an illness, so it cannot be 'prevented' in the usual way. But many children could stay with their own families if help arrived earlier — practical and emotional support for parents, money and housing advice, help with mental health or substance problems, parenting support, and safe places to go when things are going wrong at home. For children already in care, the focus is on preventing problems getting worse: keeping placements stable, avoiding unnecessary moves, and keeping siblings and school links together where possible.

Vaccines

Children in foster care should have the same routine immunisations as every other child, on the usual schedule for their age. Bring any record you have to the first health check so missed jabs can be caught up. Adults caring for children should also keep their own vaccinations up to date — ask your pharmacist or GP surgery what you need.

Screening programmes

Children in care are offered a health assessment soon after they arrive, then regular reviews afterwards. These check growth, development, teeth, hearing, vision, immunisations and emotional wellbeing, and are a chance to catch problems early. Dental checks are usually recommended at least once a year. Young people moving out of care should have a health plan and know how to register with a doctor and dentist.

Complications

If left untreated

• Repeated placement moves, which can make it harder for a child to trust adults
• Unrecognised or untreated mental health problems, including anxiety, depression and trauma responses
• Missed education, gaps in learning, or leaving school with poor qualifications
• Untreated physical problems such as sore teeth, poor eyesight, hearing problems or missed immunisations
• Difficulties making and keeping friendships
• Higher risk of homelessness, unemployment and loneliness in early adult life if support stops too soon
• Strain on foster carers, siblings and birth families that could have been eased with support

Long-term outlook

The picture is genuinely hopeful. What makes the biggest difference is not the child's past but what happens next: a steady home, adults who do not give up, keeping up with school, and timely help for health and emotional needs. Children who have had a rough start often go on to do very well with the right support around them. If things feel hard right now, please speak to someone rather than wait — help is available, and asking for it is a sign of strength, not failure.

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