risk of FASD in Vietnam?

It would be unusual to have FASD in Hanoi, most mothers are drug and alcahol free. The other problem is agent orange, the further North you go the lessor the problem. I think that FASD is more a HCMC problem. Brendan

It was my understanding that the incidence of alcohol abuse is very low in the more rural areas of Vietnam. Abuse is higher in Hanoi and Ho Chi Minh City, where it is more common to find social drinking among younger women. Our agency doesn't work in either of those cities and I don't know of anyone who has had concerns with their referrals. However, there is often very little medical/family info on the children from Vietnam so there wouldn't be many ways to evaluate the risk. In the end, we trusted our agency. It also is not something I've seen discussed much in Vietnam forums, and if it was prevalent, I would think it would have come up. By the way, good luck with your husband :)

Thank you both very much for getting in touch with me concerning FASD in Vietnamese adopted children. I do appreciate it. I also appreciate the wishing me luck with my spouse. I think I need quite a bit of luck there, but we'll try after the new year. We pay in our own health insurance and that's the big whopper financial issue.. Amy K, NJ

Amy, Statistically, it appears that the incidence of Fetal Alcohol Spectrum Disorder is fairly low in children adopted from Vietnam. However, statistics are meaningless if YOU happen to be the one parent in thousands whose child comes home with FASD or any other serious medical issue. I remember reading, not long ago, about a Guatemalan child who was diagnosed with FASD after adoption. The adoptive parents were shocked, as they had never heard of it occurring in Guatemalan kids. They, like most people, presumed that FASD didn't occur in Guatemala, because of the poverty of the birthmothers and a culture in which social drinking was primarily a male prerogative. Adoption requires a huge leap of faith, because we often know so little about the children we adopt and about their birth families. We can say what the "usual" situation is, but there are always kids and birthparents who don't fit the mold. In just about every country in the world, including countries where the prevailing religion forbids alcohol use, there are some people who drink, and some people who drink to excess. Alcohol use, as well as alcohol abuse, tends to be much more common in men, in a lot of these countries, but there inevitably will be some women who drink and at least a few female alcoholics. In the countries from which Americans adopt, many of the women relinquishing babies have not had good educations and good health services. They may not know that drinking, even in moderation, during pregnancy can harm the fetus. Even if they are not problem drinkers, they may drink before they realize they are pregnant, or may drink without realizing that ANY alcohol use during pregnancy should be avoided. And, while adoptive parents like to imagine that their children's birthparents are innocent victims of circumstance and cultural or political forces, the fact is that, in nearly all countries, at least a few of the children available for adoption are the offspring of prostitutes and other people associated with the society's seamier side. These birthparents are part of a milieu in which the use of alcohol and drugs is common. Adoptive parents may or may not be able to learn, before completing an adoption, whether a given child's birthmother had a lifestyle that might bring her into contact with alcohol or drugs. Also, FASD isn't necessarily something that can be detected right away. Not all children with FASD have the physical features associated with prenatal alcohol exposure. And behavioral and intellectual problems related to FASD may not become evident until a child is of school age. "Normal" toddlers, for example, are impulsive and don't understand cause and effect; it is only when a child is older and continues to be wildly impulsive and not to understand cause and effect that we suspect FASD. Thus, even orphanage workers trained to recognize FASD -- and most overseas orphanage workers are NOT aware of FASD -- could easily refer an alcohol-exposed child as healthy. In short, while you are wise to recognize a medical issue that you would find difficult to handle, and to try to minimize the risk of getting a child with that medical issue, there are no guarantees. Alcohol is widely available in Vietnam, especially in the big cities, and some women do drink. As a result, there is a risk that a Vietnamese child "could" be born with FASD, and "could" be referred to an adoptive family who has not expressed a willingness to accept a child with this special need. As to drugs, the same is true. There are Vietnamese women who use drugs, just as there are women in most countries who use drugs. Some children born to such women might show early signs of problems, but others might not. You may or may not receive any information that a child referred to you was drug-exposed in utero. You might worry about a child if you heard that the birthmother was a bar hostess in Ho Chi Minh City, but if the child was abandoned and showed no signs of problems when brought to the orphanage, you would not have even this red flag. I adopted from China ten years ago. At the time, parents were told, "There is no HIV in China," except maybe in seacoast cities, where foreign sailors mingled with the local population. Well, of course, we know now that there is lots of HIV in China, even in rural areas in the central part of the country. In one poor, central Chinese province, the source of infection of thousands of people was an improperly run platelet donation program, which was actively encouraged by the local government. In China, as elsewhere, infected women passed the infection to their children. Adoptive parents are basically just lucky that more kids didn't come home with it, especially since testing of children was not done for a long time, and since there was a great deal of denial in official China. People also say that there is no alcohol abuse by women in China. Again, it is baloney. There are Chinese women who drink, and who may have had alcohol during pregnancy. Alcoholism may not be as serious a social problem as it is in Russia, but it certainly exists. The Chinese manufacture very strong liquor, and if you go to a Chinese banquet, you will find that people engage in lots of toasts, which all conclude with, "Kampai!" or "Drink up!" It is usually a "guy thing" and it is usually the foreign businesspeople who get falling-down drunk, because they don't realize that they are drinking very high proof spirits. Still, women have easy access to the booze, and may well drink it. FASD is not generally recognized in the medical communities of many countries, including China. And with most of the children being referred while under age two, most orphanage workers and doctors probably wouldn't see signs of FASD, even if they did know what to look for. Again, adoptive parents have been plain-old-fashioned-lucky that they did not receive alcohol-exposed kids. All in all, you probably WILL find that the risk of getting an alcohol- or drug-exposed baby is less in Asian countries than it is in Eastern European countries. However, do recognize that there are no certainties. Your child is most likely to be healthy, except for the usual crud found in group living situations. However, it IS possible that he/she will have alcohol or drug exposure, or a major health issue of another sort. Working with a good agency will help to ensure that you get every scrap of information that is known about a given child, so you can make a somewhat informed decision about whether to adopt him/her. However, some information about the child may be unknown even to the caregivers, and the agency could well be blameless if you wind up with a child who has a medical issue. Sharon

Amy, Statistically, it appears that the incidence of Fetal Alcohol Spectrum Disorder is fairly low in children adopted from Vietnam. However, statistics are meaningless if YOU happen to be the one parent in thousands whose child comes home with FASD or any other serious medical issue. I remember reading, not long ago, about a Guatemalan child who was diagnosed with FASD after adoption. The adoptive parents were shocked, as they had never heard of it occurring in Guatemalan kids. They, like most people, presumed that FASD didn't occur in Guatemala, because of the poverty of the birthmothers and a culture in which social drinking was primarily a male prerogative. Adoption requires a huge leap of faith, because we often know so little about the children we adopt and about their birth families. We can say what the "usual" situation is, but there are always kids and birthparents who don't fit the mold. In just about every country in the world, including countries where the prevailing religion forbids alcohol use, there are some people who drink, and some people who drink to excess. Alcohol use, as well as alcohol abuse, tends to be much more common in men, in a lot of these countries, but there inevitably will be some women who drink and at least a few female alcoholics. In the countries from which Americans adopt, many of the women relinquishing babies have not had good educations and good health services. They may not know that drinking, even in moderation, during pregnancy can harm the fetus. Even if they are not problem drinkers, they may drink before they realize they are pregnant, or may drink without realizing that ANY alcohol use during pregnancy should be avoided. And, while adoptive parents like to imagine that their children's birthparents are innocent victims of circumstance and cultural or political forces, the fact is that, in nearly all countries, at least a few of the children available for adoption are the offspring of prostitutes and other people associated with the society's seamier side. These birthparents are part of a milieu in which the use of alcohol and drugs is common. Adoptive parents may or may not be able to learn, before completing an adoption, whether a given child's birthmother had a lifestyle that might bring her into contact with alcohol or drugs. Also, FASD isn't necessarily something that can be detected right away. Not all children with FASD have the physical features associated with prenatal alcohol exposure. And behavioral and intellectual problems related to FASD may not become evident until a child is of school age. "Normal" toddlers, for example, are impulsive and don't understand cause and effect; it is only when a child is older and continues to be wildly impulsive and not to understand cause and effect that we suspect FASD. Thus, even orphanage workers trained to recognize FASD -- and most overseas orphanage workers are NOT aware of FASD -- could easily refer an alcohol-exposed child as healthy. In short, while you are wise to recognize a medical issue that you would find difficult to handle, and to try to minimize the risk of getting a child with that medical issue, there are no guarantees. Alcohol is widely available in Vietnam, especially in the big cities, and some women do drink. As a result, there is a risk that a Vietnamese child "could" be born with FASD, and "could" be referred to an adoptive family who has not expressed a willingness to accept a child with this special need. As to drugs, the same is true. There are Vietnamese women who use drugs, just as there are women in most countries who use drugs. Some children born to such women might show early signs of problems, but others might not. You may or may not receive any information that a child referred to you was drug-exposed in utero. You might worry about a child if you heard that the birthmother was a bar hostess in Ho Chi Minh City, but if the child was abandoned and showed no signs of problems when brought to the orphanage, you would not have even this red flag. I adopted from China ten years ago. At the time, parents were told, "There is no HIV in China," except maybe in seacoast cities, where foreign sailors mingled with the local population. Well, of course, we know now that there is lots of HIV in China, even in rural areas in the central part of the country. In one poor, central Chinese province, the source of infection of thousands of people was an improperly run platelet donation program, which was actively encouraged by the local government. In China, as elsewhere, infected women passed the infection to their children. Adoptive parents are basically just lucky that more kids didn't come home with it, especially since testing of children was not done for a long time, and since there was a great deal of denial in official China. People also say that there is no alcohol abuse by women in China. Again, it is baloney. There are Chinese women who drink, and who may have had alcohol during pregnancy. Alcoholism may not be as serious a social problem as it is in Russia, but it certainly exists. The Chinese manufacture very strong liquor, and if you go to a Chinese banquet, you will find that people engage in lots of toasts, which all conclude with, "Kampai!" or "Drink up!" It is usually a "guy thing" and it is usually the foreign businesspeople who get falling-down drunk, because they don't realize that they are drinking very high proof spirits. Still, women have easy access to the booze, and may well drink it. FASD is not generally recognized in the medical communities of many countries, including China. And with most of the children being referred while under age two, most orphanage workers and doctors probably wouldn't see signs of FASD, even if they did know what to look for. Again, adoptive parents have been plain-old-fashioned-lucky that they did not receive alcohol-exposed kids. All in all, you probably WILL find that the risk of getting an alcohol- or drug-exposed baby is less in Asian countries than it is in Eastern European countries. However, do recognize that there are no certainties. Your child is most likely to be healthy, except for the usual crud found in group living situations. However, it IS possible that he/she will have alcohol or drug exposure, or a major health issue of another sort. Working with a good agency will help to ensure that you get every scrap of information that is known about a given child, so you can make a somewhat informed decision about whether to adopt him/her. However, some information about the child may be unknown even to the caregivers, and the agency could well be blameless if you wind up with a child who has a medical issue. Sharon

Amy, Statistically, it appears that the incidence of Fetal Alcohol Spectrum Disorder is fairly low in children adopted from Vietnam. However, statistics are meaningless if YOU happen to be the one parent in thousands whose child comes home with FASD or any other serious medical issue. I remember reading, not long ago, about a Guatemalan child who was diagnosed with FASD after adoption. The adoptive parents were shocked, as they had never heard of it occurring in Guatemalan kids. They, like most people, presumed that FASD didn't occur in Guatemala, because of the poverty of the birthmothers and a culture in which social drinking was primarily a male prerogative. Adoption requires a huge leap of faith, because we often know so little about the children we adopt and about their birth families. We can say what the "usual" situation is, but there are always kids and birthparents who don't fit the mold. In just about every country in the world, including countries where the prevailing religion forbids alcohol use, there are some people who drink, and some people who drink to excess. Alcohol use, as well as alcohol abuse, tends to be much more common in men, in a lot of these countries, but there inevitably will be some women who drink and at least a few female alcoholics. In the countries from which Americans adopt, many of the women relinquishing babies have not had good educations and good health services. They may not know that drinking, even in moderation, during pregnancy can harm the fetus. Even if they are not problem drinkers, they may drink before they realize they are pregnant, or may drink without realizing that ANY alcohol use during pregnancy should be avoided. And, while adoptive parents like to imagine that their children's birthparents are innocent victims of circumstance and cultural or political forces, the fact is that, in nearly all countries, at least a few of the children available for adoption are the offspring of prostitutes and other people associated with the society's seamier side. These birthparents are part of a milieu in which the use of alcohol and drugs is common. Adoptive parents may or may not be able to learn, before completing an adoption, whether a given child's birthmother had a lifestyle that might bring her into contact with alcohol or drugs. Also, FASD isn't necessarily something that can be detected right away. Not all children with FASD have the physical features associated with prenatal alcohol exposure. And behavioral and intellectual problems related to FASD may not become evident until a child is of school age. "Normal" toddlers, for example, are impulsive and don't understand cause and effect; it is only when a child is older and continues to be wildly impulsive and not to understand cause and effect that we suspect FASD. Thus, even orphanage workers trained to recognize FASD -- and most overseas orphanage workers are NOT aware of FASD -- could easily refer an alcohol-exposed child as healthy. In short, while you are wise to recognize a medical issue that you would find difficult to handle, and to try to minimize the risk of getting a child with that medical issue, there are no guarantees. Alcohol is widely available in Vietnam, especially in the big cities, and some women do drink. As a result, there is a risk that a Vietnamese child "could" be born with FASD, and "could" be referred to an adoptive family who has not expressed a willingness to accept a child with this special need. As to drugs, the same is true. There are Vietnamese women who use drugs, just as there are women in most countries who use drugs. Some children born to such women might show early signs of problems, but others might not. You may or may not receive any information that a child referred to you was drug-exposed in utero. You might worry about a child if you heard that the birthmother was a bar hostess in Ho Chi Minh City, but if the child was abandoned and showed no signs of problems when brought to the orphanage, you would not have even this red flag. I adopted from China ten years ago. At the time, parents were told, "There is no HIV in China," except maybe in seacoast cities, where foreign sailors mingled with the local population. Well, of course, we know now that there is lots of HIV in China, even in rural areas in the central part of the country. In one poor, central Chinese province, the source of infection of thousands of people was an improperly run platelet donation program, which was actively encouraged by the local government. In China, as elsewhere, infected women passed the infection to their children. Adoptive parents are basically just lucky that more kids didn't come home with it, especially since testing of children was not done for a long time, and since there was a great deal of denial in official China. People also say that there is no alcohol abuse by women in China. Again, it is baloney. There are Chinese women who drink, and who may have had alcohol during pregnancy. Alcoholism may not be as serious a social problem as it is in Russia, but it certainly exists. The Chinese manufacture very strong liquor, and if you go to a Chinese banquet, you will find that people engage in lots of toasts, which all conclude with, "Kampai!" or "Drink up!" It is usually a "guy thing" and it is usually the foreign businesspeople who get falling-down drunk, because they don't realize that they are drinking very high proof spirits. Still, women have easy access to the booze, and may well drink it. FASD is not generally recognized in the medical communities of many countries, including China. And with most of the children being referred while under age two, most orphanage workers and doctors probably wouldn't see signs of FASD, even if they did know what to look for. Again, adoptive parents have been plain-old-fashioned-lucky that they did not receive alcohol-exposed kids. All in all, you probably WILL find that the risk of getting an alcohol- or drug-exposed baby is less in Asian countries than it is in Eastern European countries. However, do recognize that there are no certainties. Your child is most likely to be healthy, except for the usual crud found in group living situations. However, it IS possible that he/she will have alcohol or drug exposure, or a major health issue of another sort. Working with a good agency will help to ensure that you get every scrap of information that is known about a given child, so you can make a somewhat informed decision about whether to adopt him/her. However, some information about the child may be unknown even to the caregivers, and the agency could well be blameless if you wind up with a child who has a medical issue. Sharon