I have heard than many orphanage children that have developmental delays may also suffer from zinc deficiency? Is this correct and what can we do to manage it?

As with many other types of other vitamin deficiencies found in the internationally adopted child, zinc deficiency has been linked to many of the problems found in these children. Attention deficit hyperactivity disorder, learning difficulties, growth and developmental delays, as well as immune dysfunction have all been linked to zinc deficiency. However, it is still not clearly understood if zinc deficiency is the primary cause of these conditions, or if it is the institutional environment. What is known is the fact that after zinc deficiency is appropriately treated, some of the developmental and behavioral problems improve to a degree.

Dietary factors and environmental health factors that may cause Zinc deficiency:

1) Lack of meat, fish, poultry
2) Diets high in fiber (legumes & cereals) will inhibit Zinc absorption
3) Diseases of the intestinal tract that cause poor absorption (enteritis)
4) Chronic diarrhea secondary to infections cause excessive loss of zinc

Clinical signs of zinc deficiency are not specific but may include:

  1. Enlarged liver and spleen
  2. Irritability
  3. Diarrhea
  4. Skin rashes around, eyes, nose, and mouth
  5. Hair thinning and loss
  6. Friable nails

As you can see, zinc deficiency is not easy to diagnose. Many American physicians do not usually consider such a medical condition in their daily routine medical analysis. Before it can be diagnosed, it first must be thought about. All internationally adopted children should be considered high risk for zinc deficiency.

Zinc deficiency can be associated with numerous medical problems. Growth delays are found in many internationally adopted children, as is zinc deficiency. Zinc is very important in the regulation and synthesis of many types of different hormones, such as growth hormone, thyroid, and androgens. This is why many of the zinc-deficient children are smaller than their peers.

Zinc deficiency is additionally associated with an increasing susceptibility to infections, and with a prolonged recovery rate. Children that reside in an institutional environments are prone to recurrent infections because of crowded living conditions. Orphan children that also suffer from zinc deficiency take much longer to recover from even a simple ear infection.

Zinc-deficient children are also prone to develop parasitic infection. It is not definite if the reason is because of poor hygiene in a crowded environment, but it is recognized that intestinal parasites are better able to survive in a zinc-deficient host.

Cognitive developmental delays are also associated with zinc deficiency. The effects of this deficiency depend on the age when it occurs. Children seem to be more vulnerable to the cognitive effects of zinc deficiency during periods of rapid growth.

Some of the cognitive developmental problems associated with this conditions are:

  1. Behavioral issues
  2. Impaired response to stress
  3. Short-term memory deficits
  4. Lack of problem-solving skills
  5. Spatial learning problems

The medical community believes that zinc can play an important role as adjunctive therapy to stimulant medication in the treatment of attention deficit disorder. While ADHD is another medical condition found in internationally adopted children, it is also found commonly in children from the general population in the United States. There are several studies that state that ADHD children have a decreasing Zinc level. This has also been my personal experience in private practice.

The relationship between international adoption, zinc deficiency, growth delays, and behavioral problems remains a mystery. I am convinced that there is an association, but a cause-and-effect scenario still needs to be investigated.


The information and advice provided is intended to be general information, NOT advice on how to deal with a particular child’s situation or problem. If your child has a specific problem, you need to ask your pediatrician about it. Only after a careful history and physical exam can a medical diagnosis and treatment plan be made. This website does not constitute a physician-patient relationship.