While they are children first, children who are adopted may have histories and previous care situations that can make their medical needs a little different than those of biological children.

Children who are adopted internationally likely lived in an institutionalized or orphanage setting for at least some length of time. While a handful of countries utilize a foster care system, it is unfortunately not the norm.

Parasites and other illnesses are common in group care situations. Furthermore, consistent one-on-one attention is generally not possible and as a result, children can experience some physical and mental delays. Unfortunately, children’s emotional needs are not always met, either. And, of course, most children in orphanages are not able to receive the sophisticated medical care that is available in the United States.

Visiting the Pediatrician

Most parents wish to bring their child to their pediatrician shortly after arriving home. However, it’s best to select a pediatrician in advance who you know has a practice that includes children who were adopted internationally. You might find that while some pediatricians are wonderful, highly competent, and intelligent, they just have not had exposure to a child born overseas and adopted at an “older” age (meaning not at birth).

Because children adopted from overseas can have medical concerns that your average biological baby probably does not (for example, scabies, intestinal parasites or incomplete vaccines, just to name a few), do not be afraid to bring up concerns.

You are your child’s best advocate and your pediatrician and their staff are there to help you.

Vaccines

Many children who are adopted from foreign countries have been vaccinated to some extent and you may have been provided with your child’s vaccination record. However, the vaccines may not be done on the same schedule your pediatrician follows or the records could be incomplete. Be sure to discuss vaccines during your first appointment.

Infectious Diseases

Upon arriving home, your pediatrician will test your child for infectious diseases such as Hepatitis B, Hepatitis C, HIV, and TB (tuberculosis).  While your child was probably already tested for these Hepatitis B and C and HIV before s/he was referred to you, and maybe even again after, it is still wise to retest. While extremely uncommon, it is possible that a child could be exposed to a disease after testing or that the labs were not run properly.

If your child is from a country where TB is prevalent, s/he should be tested for TB. Depending on the country, it might be wise to test on more than one occasion -- for example, immediately after your child arrives home and again three or six months later -- as your child could have been exposed shortly before leaving the country. It’s possible to have a negative test immediately upon arrival home that becomes positive later).

Other Blood Tests

Beyond testing for infectious diseases, it is common to run additional blood tests. Discuss the following with your pediatrician to determine whether they are recommended for your child: CBC (Complete Blood Count), lead levels, Hemoglobin with electrophoresis, thyroid levels, liver enzymes and anything else your pediatrician might recommend. Depending on your child’s history and current health, some or all of these tests may be necessary.

Parasites

As unpleasant as it is, parasites are a reality for some children who are adopted overseas. Unclean drinking water can lead to intestinal parasites and close living conditions make children in orphanages susceptible to parasitic outbreaks such as scabies and lice.