Adolescent mothers in foster care or other child protection services (CPS) programs are more likely to have their child taken into CPS care before the child’s second birthday, according to a study in Pediatrics.1 The placement of the child into CPS care then results in a continuous intergenerational cycle that, as the researchers suggest, may be mitigated by providing improved supportive services for the mother.

The Population Data Research Repository at the Manitoba Centre for Health Policy was used to form a population-based cohort comprised of 5942 adolescent mothers from Manitoba, Canada, who gave birth to their children between 1998 and 2013. Study investigators compared mothers who were in CPS care vs not in CPS care with regard to the odds of having their first child taken into a care program before the child’s second birthday.

Specifically, the researchers analyzed the child’s placement in care at any point before 2 years of birth, within 7 days of birth, between 7 days and 1 year of the child’s birth, and between 1 to 2 years of birth. Researchers adjusted for multiple covariates, including mental health and prenatal care use.

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Approximately 25% of adolescent mothers had their first child taken into CPS care within the first week of birth; 17% had their child taken into care between the first 7 days and 1 year of birth. In the adjusted analysis, adolescent mothers in CPS care had a greater odds of having a child taken into care before the child’s birthday compared with adolescent mothers not in CPS care (adjusted odds ratio [aOR] 7.53; 95% CI, 6.19-9.14). There were significantly higher odds of the mothers’ children being taken into CPS care programs in their first week of life (aOR 11.64; 95% CI 8.83-15.34), between 1 week and year 1 (aOR 3.63; 95% CI 2.79-4.71), and between their first and second birthdays (aOR 2.21; 95% CI 1.53-3.19).

The study lacked data on the reasoning behind placing children in CPS care or whether both the mother and child were placed in the care of the same provider.

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According to an accompanying editorial by Rachel P. Berger, MD, and colleagues,2 the placement of children of adolescent mothers may not be a failure that is reflected on the mother. “Placing the infant of an adolescent mother in foster care into foster care may not be a negative outcome, but rather the best outcome of all,” Dr Berger and colleagues wrote. This outcome may include “safety and support for the adolescent mother, safety of her child, and an end to the intergenerational cycle of child protective services involvement.”


  1. Wall-Wieler E, Brownell M, Singal D, Nickel N, Roos LL. The cycle of child protection services involvement: a cohort study of adolescent mothers. Pediatrics. 2018;141(6).
  2. Berger RP, Dalton E, Campbell K. Understanding the intergenerational cycle of child protective service involvement. Pediatrics. 2018;141(6).