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Health and medicine

Adoption health

The following web sites focus especially on health considerations in international adoption. International adoptees may have had poor prenatal or postnatal care, been exposed to infectious diseases and missed out on basics such as immunizations. Your child's first medical exam on arriving home should include tests to screen for diseases, parasites and abnormal development.

For health concerns in specific countries, see Country-specific resources

Abandon, Adoption, Autres Mondes, In French. Quebec pediatrician Jean-Francois Chicoine, with Remi Baril, created "Le monde est ailleurs" in 2002 to educate on the subjects of abandoned children, adoption and migration. Includes health questions in international adoption: risks, assessments, vaccination, infections, nutrition, growth, behaviour.
Adoption Medicine Travel Guide, Four articles in pdf by Deborah Borchers, M.D., walk parents through evaluating a referral, preparing for the adoption trip and completing a post-adoption medical assessment. Developmental indicators. Adoptive Families magazine.
Center for Adoption Medicine, Resources for medical and developmental issues in adoption. 80 topics, on diagnoses, development, learning, nutrition, attachment, FAS, drugs. Book lists. Ask-the-doctor service. Pediatric Care Center, University of Washington, Seattle WA.
Common Medical Problems Found in Children Adopted from Abroad, 19 problems, from Age Determination to Vision Screening. Dr. Jane Aronson.
Growth charts: Child Health Guide, U.S. growth charts, boys and girls, birth to 18 years. KidSource, via DHHS.
Growth charts: U.S. Clinical Growth Charts, Percentile curves showing body measurements in U.S. children at different ages, birth to 20 years. Length, weight, BMI, head circumference. National Center for Health Statistics.
Health and Medical Information, 32 articles, from Growth Charts for Chinese Children, to Hepatitis B. Families With Children From China, 8/12/06.
Health Issues in Intercountry Adoption, Health risks faced by children abroad. Robin Hilborn, Family Helper.
Hep B: Hepatitis B: No Guarantee, Four doctors warn of the accuracy and dangers of pre-adoption testing for Hepatitis B. Jenista, Johnson, Miller, Murray.
Hep B: International Adoption - Immunization and Hepatitis B, Vaccinations, including Hep B. Immunization Action Coalition, St. Paul MN.
Hep B: Is There Life after Hepatitis B?, Dr. Jerri Ann Jenista sees good prognosis for children with chronic hepatitis B. Jan. 1995.
Independent adoption (U.S.): Commentary, Medical risks of independent adoptions (U.S.) abroad. Poor preparation of adoptive parents. Dr. Jeri A. Jenista, in JCICS Newsletter, Fall 2001.
Infectious Disease and the Internationally Adopted Child, Infectious disease risks for international adoption. Dr. Jerri Ann Jenista. Current Opinion in Infectious Diseases 1993, 6:576-584.
Infectious Diseases and Parasites, Hep B, flu, tuberculosis, others. Jane E. Aronson, M.D.
International adoption: Health issues for families, Basic health issues. Canadian Paediatric Society, April 2005.
International Adoption Health and Medicine, Articles for the international adopter: travel health, Hepatitis B, TB, lead, malnutrition, parasites, scabies. Comeunity.
International Adoption Medicine, 44 topics: medical issues; choosing a child; interpreting medical info in referrals; travel tips; letter from Dr. Dana Johnson. 19 articles to download. International Adoption Clinic, University of Minnesota.
Medical Inadmissibility, Medical grounds for rejecting immigrants to Canada. Campbell, Cohen law firm.
Medical Issues in International Adoption, $45 online course by Adoption Learning Partners giving an overview of medical issues facing children adopted internationally. The Cradle adoption agency, Evanston IL.
Medical Kit: International Adoption Medical Kit, Pedia-Pak travel medical kit for children up to 5. Medications, supplies, handbook. $66, from Mechanicsburg PA.
Medical Kit: Pediatric Medical Travel Kit, To treat a child abroad. Drugs, supplies, info sheets. $85, from Orphan Allies, Denton TX.
Medical Resources, Diseases and conditions to which children are susceptible; country-specific issues: China, Ethiopia, Russia. Jane E. Aronson, M.D.
Preparation for International Travel, Advice; checklist; medicines to take. Jane E. Aronson, M.D.
Seeking Doctors' Advice in Adoptions From Afar, Article on assessing children's health, featuring Dr. Dana Johnson, International Adoption Clinic, University of Minnesota. Jane Gross, New York Times, Jan. 3, 2006
Tests: Medical Testing Recommended for International Adoptees, Your child's initial medical exam on coming home. Screening tests. Deborah A. Borchers, M.D. 5/17/00.
Tests: Recommended Screening Tests and Evaluations, For your child on return home. Jane E. Aronson, M.D., Pediatric Annals, updated Aug. 1, 2002.
Tests: Screening Tests, For international adoptees after arriving home. International Adoption Clinic, University of Minnesota.
When Your New Child is Sick, Dealing with a sick child from abroad. Medications to take. Focus on China. Evelyne McNamara, CA.

Medical articles in journals / Medical books

Aronson, J.E. Rickets in Chinese Children. FCC San Francisco Newsletter, 3, 34,36. 1998.

Aronson, J.E. Why is Lead a Problem? International Adoption and Health. The Yale-China Review, 6, no. 1, 30-31. 1998.

Aronson, J.E. Iodine Deficiency: How Concerned Should You Be? FCC Newsletter, 4, 10. 1997.

Aronson, J.E. et al. Lead Poisoning in Children Adopted from China. Ambulatory Paediatric Association, Abstract #45, May 1999.

Bramlett, Matthew D. et al. The Health and Well-being of Adopted Children. Pediatrics, Vol. 119 Supplement Feb. 2007, pp. S54-S60. Although adopted children may have poorer health than biological children, their parents may be doing more to ensure that they have needed health care and supportive environments.

Chen et al. Preventing Infectious Diseases During and After International Adoption, Annals of Internal Medicine, Sept. 2003. Case rates of infectious diseases in internationally adopted children; immunization status; reducing the risk. Table of five studies, giving infections found in screening internationally adopted children.

Chen, X.C. et al. (1992a). Studies on Iron Deficiency Anaemia, Rickets, and Zinc Deficiency and their Prevention among Chinese Preschool Children. Progress in Food and Nutrition Science, 16, 263-277.

Glader, B.E., & Look, K.A. Hematologic Disorders in Children from Southeast Asia. Paediatric Clinics of North America, 43, 665-681. 1996.

Hostetter, M.K.,& Johnson, D.E. Immunization Status of Adoptees from China, Russia, and Eastern Europe, Society for Paediatric Research, Abstract #851, New Orleans, LA. May 1-4. 1998.

Jenista, J.A. Chapman D. Medical problems of foreign-born adopted children. Am J Dis Child. 1987 Mar;141(3):298-302.

Jenista, J.A. Disease in adopted children from Romania. JAMA. 1992 Aug 5;268(5):601-2.

Jenista, J.A. Infectious Disease and the Internationally Adopted Child. Current Opinion in Infectious Diseases 1993, 6:576-584. Dr. Jenista discusses infectious disease risks for international adoption.

Jenista, J.A. Mitchell M.A. Health care of the internationally adopted child. Part 1: Before and at arrival into the adoptive home. J Pediatr Health Care. 1997 Mar-Apr;11(2):51-60. Part 2: Chronic care long-term medical issues. J Pediatr Health Care. 1997 May-Jun;11(3):117-26.

Jenista, J.A. Preadoption review of medical records. Pediatr Ann. 2000 Apr;29(4):212-5.

Johnson, D.E. & Traister, M. Micronutrient Deficiencies, Growth Failure and Developmental Delays Are More Prevalent than Infectious Diseases in US Adopted Chinese Orphans. Paediatric Research, #735, May 1999.

Miller, Laurie C. The Handbook of International Adoption Medicine: A Guide for Physicians, Parents, and Providers. Oxford University Press US. December 2004. 464 pages. Medical, developmental and behavioural issues. Effects of institutionalization, risks of prenatal exposures, malnutrition and developmental delays, diseases, inherited disorders and toxins. Guidelines for physicians. Attachment, disabilities, language competence, school issues, and culture and identity.

Miller, L.C. et al. Developmental Findings in Chinese Adoptees. Joint Council on International Children's Services, April 14, 1999.

Miller, L.C., Hendrie, N.W. Health of Children Adopted from China. Pediatrics, 105, no. 6, e76. 2000.

Miller, L.C. et al. Developmental and Nutritional Status of Internationally Adopted Children. Archives of Paediatric and Adolescent Medicine, 149, 40-44. 1995.

Pomerleau A. et al. Health status, cognitive and motor development of young children adopted from China, East Asia, and Russia across the first 6 months after adoption. International Journal of Behavioral Development, 2005, 29 (5), 445-457. Comparison study of 123 adopted children. East Asian children were in better physical state at time of arrival, and had the highest motor development. Children from Russia had lower cognitive development than the others. Initial cognitive development was related to height/age ratio (index of chronic malnutrition), while its change over time was related to age at time of arrival. Motor development was also related to height/age ratio, as well as to presence/absence of neurological signs at time of arrival.

Quarles, C.S. and Brodie, J.H. Primary Care of International Adoptees, American Family Physician, Vol. 58, No. 9 (Dec. 1998). Medical evaluation; parasites; diseases; developmental delay.

Adoption medical clinics - directories

Are you unsure what prenatal and postnatal care your child got? Are you skeptical about the child's medical history? You need a pre-adoption or post-adoption assessment from an adoption-sensitive pediatrician.

The health of internationally-adopted children is of special concern since the medical history may be quite vague. What is more, they may arrive home with a variety of medical and developmental problems which a family doctor would not normally see.

Here are some directories to help you find an adoption medical clinic near you. A clinic can assess your child, screen for medical and developmental anomalies and recommend specialists in areas like infectious diseases and development.

Adoption Medical Clinics in Canada and the U.S., Robin Hilborn, Family Helper.
Adoption Medicine Professionals, Doctors offering adoption health services in the U.S., Quebec and Russia. International Adoption Clinic, University of Minnesota.
Designated Medical Practitioners, Doctors abroad, by country, authorized by Citizenship and Immigration Canada to perform the immigration medical exam. CIC.
International Adoption Clinics, Doctors who will review Russian medical information. Families Thru International Adoption, Evansville IN.
International Adoption Medical Clinics, Directory of clinics and doctors in the U.S. and Canada specializing in international adoption medicine. Comeunity.
International Assn. for Medical Assistance to Travellers, Directory of English-speaking doctors abroad
Liste des pédiatres engagés en adoption internationale, In French, a list of 17 Québec pediatricians working in international adoption, by region within Québec. QuebecAdoption.Net.
Pediatricians with a Special Interest in Adoption and Foster Care Medicine, List by state. American Academy of Pediatrics.
Urgent Medical Care Abroad, Western-style clinics abroad, by country, including S.O.S. International,, and American Medical Centers, Dr. Jane Aronson.

Travellers' health information

Concerned about diseases you might acquire abroad? Get information on safe countries to visit, endemic diseases and needed vaccinations. Clinics for travellers can advise you on health precautions to take in various countries.

Adoption Travel, For international adoption travel planning: articles by parents; travel tips; adoption travel stories.
Canadian Health Network, General health information. Public Health Agency of Canada.
Consular Affairs, Country travel reports; travel warnings; health issues; travel documents. Dept. of Foreign Affairs
Travel Health, Info for travellers: vaccinations; diseases abroad; health advisories. Travel medicine clinics, by province. Public Health Agency of Canada.
Travelers' Health (CDC), Diseases by country; vaccines; travel medicine clinics. U.S. Centers for Disease Control.
Vaccines for Parents, Guide to vaccines for families traveling abroad to adopt. Dr. Jane Aronson, 2001.

Adoption health
Medical articles
Medical clinics
Travel health

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Fertility Adoption Adoption Resource Central Post-adoption Family Tree
Contact: Robin Hilborn,
Box 1353, Southampton, Ont. N0H 2L0 Canada
©2011 Robin Hilborn. All rights reserved
URLs verified, Dec 17, 2007
Updated, Apr. 15, 2011

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