June 4, 2001 -- A few weeks ago 3-year-old Ryan Butts celebrated a major accomplishment: He made a peanut butter sandwich by himself -- with no help from "Mom," who was watching from an arm's length away in their Mountain Home, Ark., kitchen. Geri Butts, 54, says witnessing that culinary feat was a special moment she would have missed if she and her husband David, 49, hadn't decided to become parents to their grandson, Ryan.
According to the U.S. Census Bureau, about 3.9 million American children under the age of 18 live in 2.5 million households headed by grandparents. For about 1.4 million of those children, the only parental figure is a grandparent.
Nonetheless, Butts says many grandparents who find themselves "suddenly parents" are "still in the closet. They don't want to talk about the situation," she says.
Many of these grandparents are still dealing with issues involving their own children, says Butts. In her case, she says simply that Ryan's mother was "not mature enough to take on the responsibilities of being a mother." Geri and David have raised Ryan since he was 2 months old and have legal custody of the boy.
Resources Are Out There
Butts says she and other local "grand" parents now meet in a support group formed by the Baxter County Family Resource Center. Among the benefits offered by the support group is information sharing on about how to qualify for programs such as WIC or Medicaid, which may help with food and healthcare costs.
Probably one of the best resources for grandparents raising grandchildren is the AARP's Grandparent Information Center. Started in 1993, the center is run by Margaret Hollidge, who describes herself as "a grandmother who 'got stuck' with the sweetest, smartest grandson for 5 years."
In Hollidge's case, she headed a multigenerational household. "My 22-year-old daughter was pregnant and I found myself becoming a co-parent of her child," she says.
Hollidge's daughter and grandson are now on their own, she says, "but we are still very close and when my grandson comes to visit me for a weekend, he says, 'Gran, it is so nice to be home.' "
Difficult Issues to Deal With
Sister Elizabeth Mullane, director of positive caring services and medical services at St. Vincent's Services in New York, often grapples with the more the difficult aspects of grandparents as parents.
Many times a grandparent takes over parenting when "the parents cannot take on their responsibility because of a substance abuse problem or because [they] are in jail," she says. And in such cases, the grandparents are very likely to feel overwhelmed.
"Probably the most important service that we can then offer to both the grandparent and the grandchild is respite care," she says -- that is, short term, temporary care of the child to give the grandparent a break from the daily routine of caregiving. "Even taking over for a few hours can be a welcome and essential relief," she says.
Even in the best circumstances it is not easy for grandparents to become parents again," says Hollidge. One particularly difficult aspect is dealing with the legalities.
"Grandparents are always reluctant to enter into formal arrangements," she says. "In many states it means having to take their own child to court to have that child declared an unfit parent."
Some states, such as California and Delaware, have passed education and medical consent laws that allow grandparents who can produce an affidavit of residence and relationship to enroll grandchildren in school and sign consents for medical care. But legislation varies widely from state to state, according to the AARP.
Discovering How Things Have Changed
According to the AARP, the average age of first grandparents -- when their first grandchild is born -- is 47, which is very different from the image of gray-haired, rocking-chair-bound grandparents in earlier generations, says Mullane. Nevertheless, she says, even at this relatively young age, "it is still true that things have changed since these grandparents were first parents."
Pediatricians can help by educating grandparents about some of those changes, says Andrea McCoy, MD, director of primary care at Temple University Children's Medical Center, in Philadelphia. For example, the "Back to Sleep" campaign is a recent effort to prevent sudden infant death syndrome, or SIDS. Grandparents need to be told that infants must be put to sleep on their backs, not on their stomachs, says McCoy, advice that runs contrary to what many of them did with their own children. "But we now know that by putting the infant on his or her back we reduce the risk of SIDS," she says.
And while many grandparents did use car seats for their own children, the technology and practice have changed in recent years.
"Grandparents need to know that infants should be in rear-facing car seats, in the back seat, until they are 1 year old and 20 pounds," says McCoy. Moreover, all children should ride "in the back seat until they are 12 years old."
Nutrition recommendations have also changed in recent years.
Many grandparents will recall being urged to "get their babies on solid food" as soon as possible, says McCoy, but that's stressed less these days. Since grandparents don't have the option of breast milk, good infant nutrition means just formula for at least four months, she says. Cereals can be started thereafter, but the infant should be kept on formula until he or she is at least a year old, she says.
"Babies should not drink [cow's] milk until they are at least a year old," says McCoy. When foods are introduced, McCoy says they should be introduced by giving "the same vegetable or fruit for at least three days. This helps us identify the foods that may cause an allergic reaction."
And for the first year babies should not be given water, honey, peanut butter, or chocolate. McCoy says she advises against water because it just "fills up the baby without giving any nutrition."
There have also been some changes in the types of immunizations given to children, McCoy says.
"Babies need 20 immunizations during the first two years of life," she says. Those include older immunizations such as measles, mumps, and rubella as well as newer vaccines like chickenpox, hepatitis B, and Prevnar, which prevents infections that cause pneumonia and meningitis.
If grandparents were raising children more than 20 years ago, they may be unaware of the danger associated with the use of baby aspirin for fever, says McCoy. Giving a baby aspirin to a child with fever may cause a serious illness called Reye's syndrome. "Acetaminophen [Tylenol] is now recommended to treat fever in children," she says.
Some other home remedies are now known to be dangerous, says McCoy. For example, putting alcohol on an infant's gums to numb teething pain is "actually poisonous," she says. "One should never rub whiskey on a baby's gums."
One thing that hasn't changed with the generations is the benefits that can be derived from exposing children to both reading and music at an early age. McCoy says she encourages all her parents and grandparents to read to infants as soon as they are born. On a personal level, she also "believes that listening to classical music may actually help children learn later on."
Finally, McCoy says that grandparents who are raising grandchildren should regard their pediatricians as resources. "When in doubt ask the doctor," she says.
The AARP Grandparent Information Center can be reached at 202-434-2296. Another organization, Generations United, at 202-638-1263, also is a good source for parenting information for grandparents.
