Medical Issues in Adoption
Before You Adopt
Adopting a child is an extremely rewarding experience for many families. If you're considering adoption, here are some things to know about the health and medical care of an adopted child, before, during, and after the adoption.
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 can get a sense of the child's general health by spending time with him or her before the adoption or by serving as a foster parent first.
Before you adopt, try 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 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 (STDs) 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 might be able to choose the age of the child you want to adopt and what medical conditions you feel able to accept. Discussing these issues can help you clarify your feelings and priorities.
With international adoptions, you're likely to receive photographs of the child, but reliable, complete health and family information may not be available. If possible, consider making a trip to meet the child before deciding to adopt. You can find out about restrictions that different countries may have from the U.S. Department of State.
After gathering the available health information, your adoption agency (if you have one) might be able to help you evaluate whether, given any medical issues, this child and these circumstances are a good fit for you.
Also try 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 from 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 many U.S. doctors but known to specialists or doctors with more experience with patients from that area.
Easing the Transition
Once you've decided to adopt 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 transition into your home.
You may also want to arrange for the child to bring along some personal belongings. The touch and smell of a favorite toy or an old piece of clothing can help kids adjust.
Gathering Important Information
When you pick up your child, it may be your only chance to gather this type of information. Here are a few questions 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?
- What music has the child heard? Are there any favorite songs?
- What does the child usually wear? What does the child usually play with, and 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?
- How does your child get along with other kids? 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 previous caregivers 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.
Kids With Special Needs
The term "special needs" is applied to any condition that may make it harder for a child to be adopted. Kids 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. Try to learn as much as you can about the child's condition and the special care that's likely to be needed before you make a final decision on adoption. Parents of other children with similar conditions can be a valuable resource both before and after the adoption.
Health Care When Your Child Comes Home
Soon after coming home, your child should visit your doctor or a doctor who specializes in caring for adopted children for a checkup, which will let you address any known or previously undetected medical issues.
If you adopt 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 the doctor you choose. This can help your child avoid unnecessary tests. Especially if your child was born in another country, the doctor may want to provide vaccinations.
Potential Health Problems
Adopted children tend to be screened for a number of conditions once they're placed in permanent care. Depending on a child's risk factors and the completeness of the medical records, the doctor may want to look for:
- high blood lead levels
- developmental delays
- hepatitis B and C
- intestinal parasites
- impaired hearing and vision
- metabolic disorders
- psychological problems (such as attachment problems)
- fetal alcohol syndrome or fetal alcohol effects
- thyroid conditions
- tooth decay
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 they persist, call your doctor.
Internationally adopted children can 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.
It's also common for adopted kids to have 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 time and appropriate medical care, although some kids may require counseling.
Talk to your 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, the better you'll be able to make informed decisions about medical care and ease the transition into family life.