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Medical Issues in International Adoption
by Robert Needlman, M.D., F.A.A.P.
reviewed by Laura Jana, M.D., F.A.A.P.
Children adopted from other parts of the world often have medical problems. Most of these get better with treatment; rarely are they life threatening. Physicians who have training in international adoption should evaluate these children, because some of their illnesses are unusual among U.S.-born children and may go unrecognized by the average pediatrician. Many doctors refer newly adopted children to specialized international adoption clinics. Here is a brief rundown of the key medical issues.
- Immunizations: Immunization records from overseas are often incomplete or inaccurate. Also, there is no guarantee that the vaccines given were not outdated or of poor quality. Many children need additional immunizations once they arrive in the United States.
- Infections: Common infections in internationally adopted children include intestinal parasites, hepatitis B and C, tuberculosis, and in some countries, HIV. The parasites are usually easy to treat once detected. Other infections may require longer-term treatment. All internationally adopted children need to be evaluated for potentially serious infectious diseases.
- Nutrition: Many of the children arrive in the United States with nutritional problems, including a general lack of adequate calories and protein, iron deficiency, and lead poisoning. Early, severe malnutrition can have long-term developmental effects and in some cases can contribute to learning and attention problems.
Malnutrition often slows down physical growth. Many internationally adopted children are smaller and appear younger than they really are. Often, no one knows the child's exact birth date, so doctors have to guess the child's age in order to gauge the degree of malnutrition.
The good news is, even though nutrition is a problem for many internationally adopted children, most of them recover from any nutritional deficits very quickly after adoption.
- Congenital problems: In many countries, poverty and a lack of social support make it impossible for birth mothers to raise their children. The same forces also make it more likely that the mother will have had poor prenatal care and inadequate nutrition. She may also have been a victim of alcoholism and drug addiction. Diseases, including HIV and other sexually transmitted diseases, are additional dangers. Such illness in the mother can have long-term effects on the baby. For more information, see "Alcohol and Drugs during Pregnancy".
- Variations in geography and time: A child's medical issues often depend on his country of origin. For example, children from Russia are more likely to have alcohol-related problems, including fetal alcohol syndrome, than are children from China. Medical risks also change over time, as public health measures lower the risks for some diseases while war and natural disasters send others spiraling higher.
Most internationally adopted children arrive with treatable medical problems. Long-term ill effects, when present, often involve learning, behavioral, and emotional problems.
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Created February 24, 2001
Reviewed February 27, 2001
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