Adopting a child from another country is an exciting and adventurous endeavor. International adoption brings cross-cultural learning, potentially transracial connections within your family, and possibly some medical information or concerns. When transitioning to a different country, your child’s overall health could have long-lasting impacts, so it is best to be informed as much as possible in hopes of then reducing future issues that could arise.

Each country is unique in its development and policies. Their specific government structure as well as the overall economic state of the country could have implications for your adopted child as this might impact the overall health of the birth mother and birth father. By researching and understanding the country of choice by which you are adopting from, a broader perspective could be gained on your child’s genetic makeup and environmental factors which could impact her or his future. Your specific international adoption doctor of choice should have up-to-date information on each country. Consequently, information changes rapidly in the medical field, so it is invaluable to have a trustworthy doctor who can provide this knowledge for your family’s benefit.

Considerations such as psychological trauma, up-to-date vaccinations, potential malnourishment or disease would be assessed by your international adoption doctor. Additionally, here are some other important topics to know about if you are adopting your child internationally: information regarding the international adoption agency, prenatal exposure (if this is accessible or not), evaluation of the child’s health, open adoption (if applicable) within international adoption and country/continent-specific information, and more.

Your child’s health issues could range from mild to complex, which is why it is so important to listen to your international adoption doctor.

Where to Start 

Pediatrics in Review mentions that only 20% of all internationally adopted children have no special medical or developmental concerns. And 60% of internationally adopted children have a mild to moderate problem, and 20% have a severe problem. As an adoptive family, the hope would then be to mitigate the medical issues at hand by first seeking out a trustworthy and capable international adoption doctor to set the foundation for a successful transition for your child. To find a reputable pediatrician, Healthy Children is an excellent resource; this website includes specifications such as the preferred language spoken and exact location you require. You could also get a referral from your family doctor, if preferred. Once you have secured the doctor of your choice, her or his knowledge should extend to your understanding of what is to come on your international adoption journey.

Collecting Information from International Agency 

Most international adoptions are conducted through an international adoption agency and sometimes through an orphanage. Collecting as much information prior to your visit as well as during your international visit is important for future medical assessments. Any documents the adoption agency provides to you could prove to be helpful for your international adoption doctor; this type of information would include details that you could glean by questioning the social worker or administrator at the adoption agency or orphanage.

As mentioned within Medical Issues in Internationally Adopted Children, generally, children are placed for international adoption due to abandonment, poverty, illness, death of the child’s parents, or severe family dysfunction (such as alcoholism, drug abuse, child abuse, or child neglect). Any of these reasons bring the possibility of health issues and are important to be documented for your doctor to then assess.

Here are some questions for consideration:

Pregnancy and Birth

-What was the weight of the child at birth?

-Were there complications during pregnancy or childbirth? (Drug and alcohol exposure in pregnancy could be a factor.)

Housing and Care

-Where did the child live, and what type of care did he or she receive? (Oftentimes, children thrive when they are out of an unsafe or unclean environment as this could exasperate medical conditions or psychological threats.)

Biological Parents

-What are their ages, if known, and general health conditions?

Medical Care

-Has the child received any vaccinations or has he or she been diagnosed with any medical issues?

Prenatal Exposure – Thoughts

Drug and alcohol exposure is a big topic for your adoption journey—one that is very personal to individual families who are in the process of adopting a child. It is important to understand the risks and make decisions with research-based knowledge and the guidance of medical professionals. A podcast guide on prenatal exposure to note for your research is the following: Infant Adoption Guide. When we began our process to adopt a child, we answered a very thorough document of criteria based on “what we would accept” in terms of prenatal exposure. There should always be ample honesty from the adoption agency regarding this subject.

When adopting internationally, it has been noted that sometimes documents can be falsified or do not exist at all. These prenatal exposure decisions could impact the rest of your life as well as your child’s. It is a good idea to be knowledgeable on this subject with the help of your international adoption doctor. Even in the absence of previous health documents, there are sometimes physical markings of prenatal exposure. Knowledge is power,

especially within this subject area. This easy-to-read resource from Adoptmed.org is highly impactful with some great links to educational websites included.

There has been a great deal of research and studies completed on the effects of drugs and alcohol to babies in the womb and also how a loving, nurturing, and safe environment may be able to mitigate some long-term effects within these children. In some cases, these impacts are lifelong for the child. This article called “Baby Steps” discusses the importance of a loving and stable home and how imperative it is to create attachment with your child. Attachment is, of course, important for biological and adopted children alike; yet, with children who were adopted, the importance of a bond is key in building a healthy and loving foundation, because even though adoption can be beautiful, adoption begins from loss.

Evaluation of Child’s Health 

Medical evaluation—upon your child’s arrival—is important because you need to assess what medical attention is required, usually within the first weeks. It is advisable to cocoon at home within the first few weeks of arrival as the child may have a simple pediatric condition such as a URI (upper respiratory infections), gastroenteritis, or skin infections as mentioned on the World Travelers of America website. It might be tempting to invite extended family over to meet your child for the first time or take your kiddo out to various functions, but having that time to quarantine at home is important for your child’s health to eliminate any simple pediatric conditions.

An initial health evaluation could be done by your adoption specialist doctor, and if your child has special needs, then an assessment would be further carried out by medical specialists as stated on the Healthy Children website. An example of a further medical specialist could be a dentist as teeth can ‘paint a picture’ of the overall health of a child. During the first medical visit, previous immunization records should be reviewed as well as reviewing the health risk factors that your child may have been exposed to while in her or his country of birth. It is additionally recommended to order screening tests. Having the initial evaluation of your child’s health may set the foundation for his or her happy and healthy future within your family.

Open Adoption within an International Adoption 

If an adoptive family were to have open contact with the birth mom and/or birth dad, questions can then be asked about the child’s medical history. In some cases, the full story of the child’s background may not be disclosed to the adoptive family, so it is good to be aware that there may be missing pieces to the puzzle in terms of medical history.

As my husband and I were at the hospital with our daughter’s birth mom, my husband randomly asked “Do you have any allergies in your family? Any nut or shellfish allergies (something severe)?” It was something that hadn’t even crossed my mind as I was overwhelmed with the emotional roller coaster that comes with an instant placement at the hospital. My husband asking that question was very astute as the presence of a nut allergy is typically hereditary, and we would not have known had we not asked. Our child’s birth mom mentioned that her side of the family was quite healthy, and she was unaware of allergies from the birth dad’s side of the family. So it was nice to know we had a part of the answer we were looking for.

The advantage to having an open adoption with the birth parents is finding that connection and trust over time, which could reveal more disclosure in terms of family medical history. Perhaps it is only after some time has passed that a birth dad thinks to reveal a hereditary illness that occurs in some of his family members; after a trust is developed, disclosure of history may come easier. There are many advantages to maintaining an open adoption. Having the open link to your child’s family history could prove to be a great benefit to your child’s future.

Country/Continent Specific 

The 10 most popular countries to adopt from are the following: China, Democratic Republic of Congo, Ukraine, South Korea, India, Uganda, and Haiti.

Within each of these countries are specific regulations as to who can adopt, ages of the children available to adopt, as well as travel requirements. Some health checks and/or vaccinations may also be required for those adoptive families who are traveling to these countries to visit and meet their children. Vaccinations and general check-ups may be a good idea to do prior to traveling internationally to make sure all parties are healthy before entering the country of destination. Consult with your doctor to see if vaccinations and a general physical would be a good idea to do before you travel to a certain country.

Depending on which country you travel to, there may be certain vaccinations you might need to receive prior to traveling internationally (be sure to consult with your doctor regarding the country-specific vaccinations that are recommended to travelers). For instance, travelers to parts of Africa and South America where yellow fever is prevalent should receive a yellow fever vaccine and information about preventing mosquito bites. Those traveling to parts of Asia and the Indian subcontinent in the rainy season may be candidates for the Japanese Encephalitis vaccination. This is especially true if travel includes rural areas during transmission season. Rabies can also be a serious problem as well in parts of Asia, Africa, and Latin America and could also be present in Eastern Europe too.

Still in 2020, tuberculosis (TB) is a significant problem among international adoptees. TB can be a silent infection, and all children should be screened at their home arrival.

Families traveling to any areas where malaria is present should protect themselves against malaria and use DEET bug spray, specific bedding and clothing that can reduce exposure to mosquitoes, and take protective malaria-specific drugs before, during, and after their visit. Choice for an antimalarial agent depends on the destination country, so it is important to discuss these options with your doctor prior to your departure. Travelers to most parts of the world would also benefit from protection against hepatitis A and B, and in areas where the safety of food and water is not guaranteed, protection against typhoid is also desirable.

Listening to Your International Adoption Doctor 

As a general rule, listening to your international adoption doctor is extremely important in building the foundation for a happy and healthy home life with your newly adopted child (or children!). There are many factors that holistically make up the health of a child, and the knowledge and understanding from a trusted professional is a cornerstone in feeling secure in the unexplored territory of international adoption.

Additional Information & Resources: 

Care Considerations for Adopted Children (HealthyChildren.org Parent Webinar)

● Respectful Ways to Talk about Adoption: A List of Do’s & Don’ts 

Parenting After Trauma: Understanding Your Child’s Needs 

Caring for Your Adopted Child: An Essential Guide for Parents (AAP Book)

Adoption Medicine: Caring for Children and Families (AAP Book)

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