International adoption is increasing in popularity as a method of building a family; many parents choose to adopt a child because of interest in the needs of children from another country. Because health standards in other countries can be lacking, many children who come to the United States through international adoption bring medical issues with them. Schedule testing through a health care provider upon arrival; treatment may be available for some conditions.
Infectious Disease
With inadequate prevention or treatment, children born in other countries may be exposed to certain infectious diseases. Hepatitis B is a chronic infection that affects the liver and is found in many countries. Because immunization requirements may be different than those in the United States, many children overseas can be exposed. Tuberculosis (TB) is an illness that affects the lungs and contact can occur through droplets in the air. Adopted children can have a skin test to determine exposure and a chest X-ray to check for lung damage. Some parts of the world have high numbers of infections with human immunodeficiency virus and children adopted from these countries may have been exposed to the virus. Testing for infectious diseases should be done as soon as possible after arrival in the United States to avoid infecting others.
Lead Toxicity
Exposure to high levels of lead can produce lead toxicity in the bloodstream of some adopted children. Many foreign countries do not have standard testing for lead levels and there may be various causes of exposure depending on the country of origin. Children who have high levels of lead in the bloodstream are at risk for cognitive deficits, including learning disabilities, developmental delays and behavioral disorders. Lead screening should be done on an initial exam upon entering the United States after an international adoption.
Anemia
Some children who are adopted internationally arrive in the United States with anemia. Diet differences in other countries may not provide adequate nutrition; additionally, a variety of foods may not be available. Some orphanages may care for many children and food may be limited or rationed. Anemia is frequently caused by a deficiency of iron, which leads to skin pallor and decreased oxygen levels in the bloodstream. After arrival in the United States, a physician can examine for anemia in an adopted child by a blood test to determine the level of hemoglobin. Anemia is treated with iron supplementation and an increase in dietary intake of foods that contain iron, such as meats and leafy green vegetables.
Fetal Alcohol Syndrome
Babies born to mothers who drank alcohol during pregnancy may have fetal alcohol syndrome (FAS). FAS occurs throughout the world; in some countries, women may not receive prenatal care or understand the damage caused by drinking alcohol while pregnant. Because some children who are adopted internationally do not have much medical history, a child may unknowingly have FAS. Physical abnormalities may appear, such as facial deformities. Other internal symptoms may include kidney and liver defects, and hearing or vision problems. Symptoms of FAS that may appear over time include behavioral issues and mental retardation. Upon arrival to the states, schedule a visit with a physician, who can check children with suspected cases of FAS. To manage behavioral issues, you may need to schedule a psychiatric evaluation with a health care provider.
Parasites
Certain conditions before adoption can contribute to intestinal parasites in children. Areas with poor hygiene and close quarters can add to the spread of illness. Children with parasites may be asymptomatic or they may have abdominal pain and diarrhea. Parasites spread easily between people, so both children and parents should practice hand washing, especially after using the bathroom and changing diapers. Physicians can check a child's stool for microscopic bacteria and eggs that are causing the infection.
