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Adoption- Research on Long-Term Effects?

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Dear Dr. Markham,
I've learned late in life that my (slightly) younger brother was adopted. Can you direct me to any literature (scientific is fine) on the early life of the infant (first month); the process of bonding with the mother; what happens when the bond is disrupted at the age of one month? I have been searching for the truth of my brother's life for many years. I hope very much that you can help me. Thanks!


Learning that your brother was adopted late in life was likely a shock -- but probably made sense. As you say, you had been searching for the truth of your brother's life for many years, even before you knew he had been adopted. It sounds like something did not add up for you, that you were looking for some explanation. Many people who learn as adults that they were adopted say they already knew it on some level.

The more we learn about adoption, the more we realize how complicated it is. How could this adoption have affected your brother?

There are so many questions here. Let's examine each stage of "life" in turn.

What genes were given to him by his birth parents? We know that genes interact with/are modified by the environment, both in utero and throughout life, so they aren't written in stone, but they certainly have a huge impact. At the very least, they produce tendencies that are then actualized by the environment. For instance, if your brother had two short versions of 5-HTT, he would be more vulnerable to any subsequent bonding (or other) stresses.

What happened during the pregnancy? We now know that as the baby takes shape inside the mother, he is profoundly affected by environment. If his birth mother was under stress, he would have been flooded with stress hormones during development. We are still sorting out how that affects the embryo, but there is no question that it does.

Another question is how the birth mother felt about the baby she was carrying. We know that babies feel emotions at birth, although those emotions are probably experienced somewhat differently than we experience emotion -- in other words, a newborn baby feels fear, and delight, and a sense of deep connection that is probably what we later think of as love. Certainly the baby learns to interpret those emotions later, but some form of these emotions are there at birth. So at some point in utero, the baby must be already feeling emotion.

Most experts now believe that babies begin to "bond" before birth. How could that be? Well, we know that during the third trimester, babies distinguish the familiar voices of family members, and that after they're born, those voices soothe them more quickly than strangers' voices. So that familiarity could be the beginning of bonding. Even more interesting, prenatal psychologists believe that the baby feels what the mother feels. Hormones that cause the mother to feel certain emotions cross the placenta and presumably cause the baby to feel the same emotions. So a mother who feels contentment and love while she talks to her fetus will induce those feelings of love in the fetus. When he hears her voice, he will associate it with those same feelings. Again, the baby is born already somewhat bonded to the mother.

Of course, the opposite can also be true. Here's a quote from Dr. Sears:

Researchers believe that a stressed mother produces an abundance of stress hormones called catecholamines, which have been shown to, in turn, affect emotions. When catecholamines are taken from frightened animals and injected into other animals, the recipients act frightened as well. Scientists theorize that these chemical stressors cross the placenta and "frighten" the developing nervous system. If it happens often enough, the fetus actually gets used to feeling chronically stressed."

I would add that the baby will associate that anxious feeling with the voices he hears in utero, which could mean that after birth he will feel anxious while around those voices, less likely to have warm fuzzy feelings toward those voices or to be comforted by them.

I find this emerging field interesting because of the resistance of the "old guard" to these emerging theories. Studies certainly support the idea that bonding begins before birth, but there's a widespread assumption that this is not real science, that embryos can't possibly have real feelings. Of course, that's what we thought about babies not so long ago. We even routinely did minor surgery without painkillers because for some reason we thought newborns didn't feel pain!

At any rate, by the time your brother was born he had already NOT bonded with the mother who was to raise him. Whether he had bonded with his birth mother, we don't know, but we have to assume he was oriented toward her, familiar with her, looking to bond with her.


What happened to your brother during that first month of life? Was he cared for by his birth mom, or by some transitional person? Did she know she would be giving him up? Did she hold him fairly constantly -- as babies need -- or leave him to cry? When he looked at her, did she meet his gaze or look away? When he was upset, did she soothe him?

We can assume that your brother started drawing conclusions about the world as soon as he entered it. What's more, if he had a difficult temperament -- either by virtue of genetics or embryonic shaping -- he might have been difficult to care for. This is the time when parents begin to learn to read their unique baby's cues. A mother who knew she was giving him up might not really have tried. A newborn who isn't "connecting" with his caretaker could feel not only like his needs weren't being met, but also possibly that he was in danger. After all, a baby without an adult committed to his welfare is in real danger. He might well have become extremely anxious, or have "shut down."

Babies who are adopted after a month or more are often lagging in development. One of my close friends who adopted her son at six months says "It was like he was waiting for someone to come along and pay attention to him before he could really start living. Once he had me, his development took off."

We know that "Newborns are social creatures who arrive prepared to interact." (Ruth P. Newton). I highly recommend Newton's book, The Attachment Connection: Parenting a Secure & Confident Child Using the Science of Attachment Theory.The part of the book that deals with newborns is short, but she has some lovely vignettes that give you a sense of how alert and attachment-seeking newborns are, and she does a great job of explaining how healthy attachment develops and what can go wrong.

I would also highly recommend Why Love Matters: How Affection Shapes a Baby's Brain by Sue Gerhardt. The first half of this book reviews recent brain research and the way bonding affects the developing nervous system and the baby's later temperament, sense of self, and ability to cope in the world. The second half explores the pathology that can result when babies don't get the attuned care they need to develop optimally.

I don't know of any research specifically about the relationship between women and their babies when the woman knows she is giving the baby up. However, the effect might well be similar to women who can't relate in an attuned way to their babies for a different reason: depression. There's a lot of research on post-partum depression and the effect on the baby, Gerhardt has a bibliography in the back of her book that includes some of these studies.

Margot Sunderland's book The Science of Parenting is more practical and less theoretical than Gerhardt's but has an extensive bibliography of works cited, and she also gives a very good understanding for parents of how attachment influences brain development and therefore later personality.


Ok, what happens when the baby is adopted at the age of one month? Well, even if he wasn't experiencing a healthy connection with his caregiver prior to that time, he had begun to adapt to that person and that environment. He had begun to draw conclusions about the world and to shape his behavior accordingly. We know that his brain was already taking shape based on his early environment. So even if he wasn't developing a "secure" attachment in the sense of feeling that this person would reliably meet his emotional needs, he was certainly bonded in the sense that this person was feeding him, changing him, dressing him, holding him. We have to assume he was bonded, for better or worse.

Given that his environment until that time had not been ideal, I would assume that he could easily have developed a needy, or challenging termperament. Wolke and St James-Robert published a study in 1987 in the book Psychobiology and Early Development (Oxford) in which they claim that difficult temperament is a product of parent behavior and perceptions. I don't think I would go that far, but a child who is being given up for adoption would not have been likely to have received the care that would make him into an "easy" baby. That would make it more difficult to meet his needs and form a secure attachment.

In any case, the baby now enters a family where there is already another baby, not so very much older. Any baby under the age of two would have been still quite needy herself. Any mother and father would have been challenged to care for the needs of these two little ones, given the context that the new arrival was already a month old and possibly high-needs, and that they had to begin, from scratch, to bond with him. So for them to become attuned to this baby would have been much harder than if he had come to them as a newborn.

However, attuned parenting should be able to make up for that month's delay in the start of their relationship. Not easy, but certainly do-able. So parents who chose to take this baby into their arms and home should have been motivated enough to meet his needs, even if they were considerable. We can measure the health of the attachment relationship at one year, so we usually think of it developing during that full year, although of course we don't really know whether babies draw their conclusions much earlier. But we can presume that a baby who arrives in a family at one month old is still quite open to connecting with his parents. It's their job to attune to him, to make sure that he concludes they're reliably there to protect him and help him.

Here's where it gets tricky. Could it be that the baby is NOT open to connecting with the new parents because he is mourning his birth mother, with whom he had already bonded? Entirely possible. Maybe he would have had a hard time trusting them. On the other hand, we know that sooner or later the imperative to live would take over and the baby would move beyond mourning, would "forget" about the loss, would bond with this new family.

Except, somewhere inside him, is the very early experience of tremendous grief. Along with the panic of abandonment. Would this show up? Maybe not, if his adoptive parents are attuned enough. But throughout his life, there would always be a fragility. Later experiences of loss might well give rise to depression or anxiety, for instance.

I'm thinking of a man who was adopted but did not find out until after his parents' deaths when he was 50. He was shocked, said it had never occurred to him. But throughout his life, his reaction whenever a sweetheart broke up with him was to be plunged into depression. He had to check himself into a hospital with panic attacks after a serious breakup. That is an extreme reaction, and once he learned he was adopted, he was able to understand that this panic reaction when a woman left him was related to his adoption -- even though he had not known about the adoption and had been adopted during his first month of life.

So I am convinced the effect is there, even though we don't give babies credit for real feelings. But research proving it is not there yet. I know this is really what you want the research on -- what happens in the psyche of a baby who is separated from a birth mother at one month old and raised by someone else. The truth is, we don't know, because it's so hard to tease out the various strands. First, you would have to separate out kids who knew they were adopted from kids who were never told, because the "proof" of some effect would be kids who didn't even know they were adopted but showed some effect from it. (People like this man I mentioned, who had panic attacks.) But then you would have to eliminate other causes that might be affecting the adoptee, because maybe something else happened in their background to cause this issue for them. So the research would be tough.

We shouldn't ignore the early research done on babies who were orphaned or separated from parents during World War 2 in England. John Bowlby's studies of these kids is what gave rise to the entire field of Attachment Theory; he wrote his Attachment and Loss trilogy from this experience. Basically, what he found is that children, and even babies, who are separated from parents go through stages of mourning that leave them wounded and vulnerable, even once the parents return. His associate, Michael Rutter, also did a lot of research on loss, and one of his findings was that people who experienced a loss in childhood were more vulnerable to any losses that happened later in life. But I'm betting that there weren't many one month olds in Bowlby's orphanage, so we're really extrapolating from older babies.

Of course, many people will still tell you that babies who are a few weeks old don't have a preference for their parents over strangers. Simply not true -- they just are willing to let a stranger hold them. Doesn't mean they don't know the difference, or that they would not grieve if the stranger took them home.

So I guess, after this long response, that I don't know any research exploring the questions you're most concerned about. But I am completely convinced that adoption has a longterm effect, both from everything else I know about development, and from anecdotal stories.

Does that mean that people who are adopted can't be well-adjusted? Of course not. Yes, adopted children grieve a great loss, and it can be tough for them to resist the conclusion that somehow there must be something wrong with them for their birth parents to have relinquished them. But children overcome all kinds of challenges, from illness to poverty to the death of a parent. What helps them through hard times is having at least one adult who is completely committed to their well-being. When the child feels heard and understood, when he has a trusted adult to help him manage the big, scary feelings that overwhelm him, when the child feels that he is at the center of someone's world, he can process his challenge and emerge stronger. I hope this was true for your brother.
Dr. Laura

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Dr. Laura Markham is the author of three best-selling books

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