This paper describes mental health risks to the birth-to-three foster care population. The paper describes risks of a relational and contextual nature. Relational risk factors, which have been previously identified by foster care researchers and clinicians, include the following: 1. Poor attachment signaling by foster infants and toddlers; 2. Discomfort with infant and toddler dependency by some foster parents; and 3. Regulatory problems of foster infants and toddlers. Contextual risk factors include the following: 1. Lack of coordinated and coherent efforts to help foster infants and toddlers and; 2. Lack of support for the parent–child relationship during placement. A case example and discussion is offered to illustrate these risks.