It is impossible to offer a nurturing environment that meets the needs of each individual child within an orphanage. No orphanage is capable of providing the same quality of care as a family.

With that said, each orphanage will be different. Orphanages have varying levels of financial support, staff dedication and additional resources. Even the most dedicated staff will struggle without the other two and vice versa, without dedicated staff no amount of money or resources in the world could make up for quality staff.

Child-to-care-giver ratios in orphanages are often seriously disproportioned. Whether there are 9 children or 19 per one caregiver, there will inevitably be a delay calming tears, feeding hungry bellies, and changing wet diapers.

Regardless of the country, it is extremely difficult to care for many children at once. Add in the fact that some of the children in an orphanage will have additional medical or special needs that require extra time and attention, and meeting the specific emotional, physical, and mental needs of each child becomes impossible. Additionally, orphanage staff may not receive the training they need to care for the needs of children who require post-operative care or attention. Not only does this cause trauma and difficulty to the the child, but it likely causes stress for the caregivers as well.

It is important to recognize that a child from an orphanage has not had their needs met consistently and predictably. Having basic needs met in infancy and beyond form the foundation for building trust in any human. Exploring adn educationg oneself about how early experiences influence a chld's behavior and development will benefit a parent's understanding of how a child might need to be parented and supported once adopted into a family. Dr. Karyn Purvis' book, The Connected Child, is a helpful and concise guide for families. It will put into perspective a child's unusual coping skills, independence, indiscriminate friendliness or lack of eye contact, and help any parent build a connection to their child who spent time in an institutional/orphanage setting.

In an orphanage personal possessions are a foreign concept. As children grow and explore, they will have access to some toys and clothes, which are shared. It is not uncommon for a child to never have received a gift, quality 1:1 time with a caregiver or even their own pair of shoes.

Once adopted a child may not understand that all things are not shared within their family or that feelings get hurt when possessions are damaged. Additionally, a child may feel overwhelmed when they begin to acquire personal possessions.

Baths and cleanliness may not be a first priority in an orphanage. In general, children in orphanages are bathed or shower in large groups. Heated water is extremely uncommon, so bathing is not welcome or enjoyed by children from institutional settings. It is quite the opposite of the experience most Westerner's are familiar with! Few instituations are heated, or have heat only in a few common rooms. In winter months it might be too cold in the orphanage to justify a regular washing. It is almost cruel to bathe malnourished children int his atmosphere. When a child comes home to their new family, parents should not be shocked if their child's fingernails are dirty, or if their body seems like it hasn't been washed clean in the last several months. It's helful to understand that a child may fear baths, and need time to accept teh practice of washing regularly.

It is important to note that while a parent might feel the need to immediately change their child's clothes or get them bathed and smelling fresh; those smells and clothes can be a very real comfort at the moment for a child.

The diets of children in institutions are often basic and meager. Feedings are often rushed and end before a child is even full. Developing eating habits in such an environment can significantly influence a child's relationship with food. Often, children from institutions either develop the habit of hoarding/hiding and gulping down food quickly, or they have sensory issues with food. Having not experience any variety of foods, new textures and tastes may cause a child to refuse to swallow or spit out 'strange' foods. Overeating and the hoarding of food makes more sense with the knowledge that they have never learned that there is an abundance of food available when they are in a family. The holding on to food (keeping food in a pocket, allowing the child to sleep with a basket of food) may help a child to feel safe, it becomes security that there is food there when they need it. A child may never seem full because they don't know when to stop eating, since they have never had unlimited access to food or felt full before. It often takes time for a child to learn that there will always be more food for them, that they will get another meal when they are hungry again. An adult simply telling the child this fact is not enough. For a child feel food-security, they must first have some power or control over 'owning' food. A personal cabinet that is kept stocked, a basket in their room, a bag that contains treats that they can carry with them all help a child to process the new reality of food-abundance. Once a child begins voluntarily (without prompting) sharing the food from their cabinet or bag, and understands that it will be re-filled, security begins to set in.

Orphanages lack stimulation and experiences. Children may not have much interaction with the world outside their orphanage walls. In fact, they may not have that much interaction within the orphanage walls. This can make new experiences, such as walking on the grass, going to the park, or even getting into a car stressful. Also, the lack of visual and sensory input can lead to a diagnosis of cognitive delay. However, most children overcome these 'delays' over time. They simply need to process many new experiences, adjust to family life, and undersand their new language. All require patience and empathy from their new family.

Living outside of parental care may mean that a child has spent time in an orphanage. Yet, predicting specific outcomes or potential challenges for each unique child is impossible. While orphanages are not able to provide the same quality care that a family could, the more we know about orphanage care the better a child's needs will be met once they join their family.

This series was inspired by a series of blog posts written by Amy Eldridge, Director of Love Without Boundaries on their blog.

Megan Montgomery, LMSW, is the International Adoption Coordinator for AdoptionSTAR