Tinyike

For many families, adoption can be an extremely rewarding experience. But when it comes to the health and medical care of an adopted child, there are some unique issues and concerns that you may want to keep in mind before, during, and after the adoption is complete.

Gathering Information Before You Adopt
If you have an open or semi-open adoption - one in which you meet the mother and sometimes the father - you should be able to get substantial health information. In an open adoption, you may help arrange the birth mother’s prenatal care, go with her to doctor visits, and be present for the birth. You can also request health records through the agency or attorney who is arranging the adoption.

With an older child who is already living in the United States, you may be able to get a sense of the child’s general health by spending time with him or her before the adoption takes place or by serving as a foster parent beforehand. Before you adopt, it’s a good idea to have as much medical information as possible, including:

age, ethnic background, education, occupation, height, weight, and medical conditions of the birth parents
diseases or medical conditions that run in the child’s family
the health of the adopted child’s siblings
information about whether the birth mother drank alcohol, smoked, or used drugs during pregnancy
information about whether the birth mother used any prescription or over-the-counter medications during pregnancy
an indication of whether the birth mother had any sexually transmitted diseases that might affect the child’s health
the birth mother’s prenatal care
results of any tests done during pregnancy
any problems during pregnancy, labor, or delivery
the child’s weight, length, and head circumference measurements at and since birth
any medical problems the child has had
the results of any medical tests the child has had
the child’s development in relation to standard age milestones, such as sitting up, walking, or talking
a description of personality and relationships with others
information about the child’s care since birth
any physical, sexual, or emotional abuse of the child
If you adopt through an agency, you may be able to choose the age of the child you want to adopt and what medical conditions you might be willing to accept. Discussing these questions can help you and your partner clarify your feelings and priorities.

With international adoptions, you are likely to get a picture and perhaps a short video of the child, but reliable, complete health and family information may not be available. If you can afford it, and if it is feasible, it may be worth making a trip to meet the child before deciding to adopt. You can find out about different restrictions that different countries may have on this from the National Adoption Information Clearinghouse, an agency run by the U.S. government. (See additional resources page.)

Interpreting Information
Once you have gathered whatever information is available about the child you are interested in adopting, your adoption agency, if you have one, may be able to help you evaluate whether, given any medical issues, this child and these circumstances would make a good fit for you.

It’s also a good idea to get a doctor to help you interpret the child’s medical record. You may want to consult a doctor who has experience with adopted children with the same background as the one you may adopt. This is especially true if you are adopting internationally. A Russian medical record, for instance, may contain terms that are unfamiliar to most U.S. doctors but are more familiar to specialists or doctors with more knowledge about that area.

Easing Your Child’s Transition
Once you’ve decided to adopt a child or provide foster care, try to learn as much as you can about the child’s daily schedule, abilities, and likes and dislikes. Maintaining a schedule and serving foods that are familiar to the child can help ease the child’s transition into your home.

You may also want to arrange for the child to bring along some personal belongings to your home. The touch and smell of a favorite toy or an old piece of clothing may help a child sleep.

When you go to pick up your child, it may be your only chance to gather this type of information. Here are a few questions that you may want to keep in mind:

Which foods does the child like or dislike? When does the child eat and how much? Is the child allergic to anything? How is the child fed or how does the child feed himself or herself?
When does the child sleep and for how long? Does the child have a bedtime routine? Is there anything that helps the child sleep?
Does the child use the toilet on a set schedule?
How and when is the child washed or bathed? Have the child’s teeth been brushed?
What music has the child heard? Are there any favorite songs?
What does the child usually wear? What does the child usually play with? Is there a favorite toy or blanket?
What methods of comforting are most effective?
Can the child sit, crawl, or stand? What about speaking, making sentences, or recognizing colors, letters, or numbers? If your child is in school, at what level is the work?
How does your child get along with other children? With adults? Is your child especially attached to particular people?
Other things to consider:

You may want to take home pictures of the child’s foster family and familiar surroundings.
Keep track of the names, addresses, and phone numbers of everyone you meet who knows your child in case you need more information later.
Get a record of which vaccinations your child has received.
Try to get a copy of your child’s medical record or photograph it.
If you are not in touch with the birth mother, try to arrange some way you could contact her if a medical crisis arises.
Children With Special Needs
The term “special needs” is applied to any condition that may make it harder for a child to be adopted. Children with special needs may have a mental, physical, or psychological problem, or they may be older (perhaps 5 or older) or have siblings who must be adopted with them. The definition of “special needs” varies from state to state.

If you are thinking about adopting a child with special needs, you may be required by the state or an agency to take courses or get family counseling to prepare for the adoption.

Health Care When Your Child Comes Home
Soon after your child comes home, it’s a good idea to take the child to a doctor for a checkup. That way you can address any medical issues that may not have been detected yet.

If you are adopting a child who has spent time in foster care, the agency may be able to tell you where the child has been getting health care so you can either use the same providers or get the records sent to a doctor you choose. This can help your child avoid unnecessary tests. If your child was born in another country, the doctor may want to provide vaccinations.

Health Problems Your Child May Face
There are a number of conditions that adopted children tend to be screened for once they are placed in permanent care. Depending on the child’s risk factors and the completeness of the medical records, the doctor may want to test for:

anemia
blood lead levels
developmental delays
hepatitis B and C
HIV
intestinal parasites
impaired hearing and vision
metabolic disorders
psychological problems (such as attachment problems)
fetal alcohol syndrome or fetal alcohol effects
rickets
syphilis
thyroid conditions
tuberculosis
It’s not uncommon for adopted kids, particularly those who have been living in poverty, to get colds, minor infections, upset stomachs, and diarrhea shortly after arriving in their new homes. This often happens as the kids are exposed to new types of germs and a new diet. These sicknesses will likely resolve themselves as your child adjusts to the new environment. But if these issues persist, it’s a good idea to call your doctor.

Internationally adopted children, especially those from China and Eastern Europe, often have a number of other immediate medical problems. These may include infections like scabies, lice, latent tuberculosis, and intestinal parasites; rickets and other forms of malnutrition; and lead poisoning (especially in children from China).

It’s also common for adopted children to experience emotional problems related to feeding as they adjust to their new homes. These problems may include hoarding of food and eating to the point of vomiting (both signs of past food deprivation). These problems usually clear up with appropriate medical care, although some may require counseling.

Talk to your child’s doctor if you have any questions or concerns about any health and medical care issues surrounding adoption. The more you learn about your child’s health issues, the more you’ll be able to make informed decisions about his or her medical care and ease the transition into family life.

Updated and reviewed by: Amy E. Renwick, MD

Date reviewed: April 2005

Originally reviewed by: Kathleen M. Cronan, MD