Children in care often face a complex set of challenges that go beyond the emotional impact of separation from their birth families. Many arrive into care with existing physical or mental health needs, shaped by their previous experiences. Whether placed in foster homes, residential settings or kinship arrangements, these children may require additional support to help them reach their full potential.

Health in this context is rarely about a single issue. It often involves a combination of physical, emotional and developmental concerns that need careful coordination between carers, health professionals and social services. For many children in care, health is an ongoing journey, not a quick fix—and understanding the challenges they face is key to supporting them effectively.

Delayed or Missed Healthcare Before Entering Care

One of the most common issues for children entering care is a history of limited or disrupted access to healthcare. For some, appointments have been missed, vaccinations delayed or basic health concerns left untreated. This can include common childhood conditions such as asthma, eczema, dental problems or undiagnosed vision and hearing issues.

When a child comes into care, an initial health assessment is usually carried out. This helps identify any immediate concerns and puts a plan in place to ensure future health checks aren’t missed. Even so, carers and professionals often find themselves playing catch-up, working to correct health issues that have developed over time without proper treatment.

Mental Health and Emotional Wellbeing

Many children in care have experienced neglect, trauma or abuse. As a result, mental health issues are a frequent concern. Anxiety, depression, attachment disorders and post-traumatic stress symptoms are not uncommon. Some children may also show challenging behaviour or struggle with trust and emotional regulation due to instability in their early lives.

CAMHS (Child and Adolescent Mental Health Services) often become involved in providing therapy or psychological support, but access to these services can vary by region, and waiting times can be long. In the meantime, carers play a vital role in offering stability, routine and emotional reassurance. Training and support for foster carers and residential staff can make a significant difference in managing mental health needs day to day.

Developmental Delays and Learning Difficulties

Developmental delay is another issue that appears regularly among children in care. These delays can be caused by a range of factors, from prenatal exposure to drugs or alcohol to lack of stimulation and emotional connection in early childhood. Speech and language delay is particularly common, along with fine motor and cognitive development concerns.

Schools and carers may notice difficulties once the child begins formal education, with some children requiring an Education, Health and Care Plan (EHCP) to receive additional support. Early intervention from speech therapists, occupational therapists and educational psychologists can help children catch up, but this requires consistent coordination between health and education teams.

Poor Dental Health and Hygiene Habits

Oral health is often neglected before a child comes into care, with many children arriving with untreated tooth decay, gum disease or a fear of the dentist. A poor diet, lack of routine and limited supervision over tooth brushing are frequently to blame.

Upon entering care, children are usually registered with a dentist, but tackling existing dental issues can take time and often requires specialised paediatric treatment. Teaching good hygiene habits and encouraging a balanced diet are part of the ongoing support needed to rebuild overall health.

Nutrition and Growth Concerns

Nutritional concerns are another common issue. Some children arrive in care underweight due to neglect or inconsistent access to meals, while others may be overweight due to poor food choices or comfort eating. Establishing a balanced diet, encouraging regular mealtimes and addressing any anxieties around food are all part of the care process.

Health professionals monitor growth and weight as part of regular health assessments and can offer advice or referrals to dietitians where needed. For children with sensory issues or anxiety around food, progress can be slow, requiring patience and reassurance from carers and support workers.

Substance Exposure Before Birth

Some children in care have been exposed to drugs, alcohol or nicotine during pregnancy, which can lead to a range of developmental and behavioural issues. Fetal Alcohol Spectrum Disorders (FASD) in particular are often underdiagnosed but can affect learning, memory, attention and emotional regulation.

These conditions require long-term management and a specialist understanding from those involved in the child’s care. Diagnosis is not always straightforward, especially when a child’s early history is unclear, but understanding the signs can help tailor support and reduce frustration for both the child and those around them.

Lack of Continuity in Healthcare

Children in care often move between placements, and with each move comes the potential for disrupted healthcare. Appointments can be missed, referrals delayed and medical histories lost or incomplete. While efforts have been made to improve information sharing between local authorities and the NHS, this continues to be a challenge.

To combat this, designated doctors and nurses for looked-after children play a vital role. They help ensure that each child’s healthcare is consistent and that any outstanding treatments or assessments are followed through, regardless of where the child is living.

The Importance of Stable, Informed Support

Stability and informed support are two of the most crucial factors in improving the health of children in care. When children feel safe and are surrounded by adults who understand their needs, they’re more likely to thrive. Carers and key workers who receive appropriate training in trauma-informed care, attachment theory and developmental needs are better equipped to support not only the child’s physical health but their emotional recovery as well.

Building strong relationships with GPs, health visitors, dentists and mental health services also improves outcomes. When professionals work together and place the child at the centre of care planning, it creates a foundation for better health and wellbeing.

Working Towards Better Futures

The health challenges faced by children in care are often rooted in circumstances beyond their control. While many arrive into care with complex needs, the right support can make a real difference. With stability, access to healthcare and emotionally informed carers, children can begin to rebuild their health, confidence and sense of self.

It’s not always a quick process, but progress is possible. By recognising the unique challenges faced by children in care and responding with empathy, expertise and consistency, we create the conditions in which young lives can begin to heal and flourish.