Adoption Medicine

Adoption medicine is a field of medicine concerned with the care and anxieties of families and children involved in international adoptions. A multidisciplinary team of physicians works with the adopting parents before, during, and after the adoption process, helping them understand the unique risks children from their particular adoption area face.

Doctors from the fields of pediatrics, psychology, infectious diseases, rehabilitation therapy, and be-havioral/developmental medicine review the adopted child's dossier before the adoption process takes place. These professionals advise the new parents of what questions to ask, such as family history, the health of the child's siblings, the course of the mother's pregnancy, and birth of the child. With answers to these questions, the parents and physicians are better able to predict what future medical and emotional care the child will need, and what problems may be expected. This team also works with the family after adoption, examining the child and setting baseline standards for future growth and development.

There are unique medical problems the child may face in transitioning between his or her native home and his or her new one. Certain diseases are more common in specific geographical areas. In China, some intestinal parasites are more common, such as ascaris, giardia, and scabies. Impetigo is more common in orphanages than in cleaner, less crowded facilities. Human immunodeficiency virus (HIV) is seen in Romania, Haiti, and Uganda. Syphilis is common in any country where infants may be abandoned. Depending on the condition of the mother during her pregnancy, fetal alcohol syndrome may be a risk, as are other developmental delays. In general, it is felt that for every three months that a child spends in an orphanage, there may be a one-month developmental delay.

The child of a birth mother infected with hepatitis B (HBV) can be a chronic carrier. Higher risk exists for all common forms of hepatitis—hepatitis A (HAV), HBV, and hepatitis C (HCV). In some countries, there is a greater risk that the proper immunization and vaccination schedule has not been followed, leading to infections with childhood illnesses that are not a problem in more-developed countries. There are also malnutrition issues to be considered, as well as attachment problems. Metabolic problems, such as G6PD deficiency and thyroid diseases, may also be more common.

Not all children adopted from international countries will be sick or needing greater medical attention in their future. However, because of their origin location, most are at a higher risk of some disorders. In the first year of life, it is normal for any child to be sick with coughs, colds, and other minor illnesses from eight to 12 times. The stress on the adopting family from these normal exposures to new environments may be higher in adoption situations. Information about the child's initial health can help ease the stress of these normal childhood experiences. This is why adoption medicine is becoming more critical in helping families attain successful, healthy adoptions.