International Adoption: Ask the Right Questions About Child's Health

There’s been a growing allure surrounding international adoption ever since the likes of Angelina Jolie, Madonna and Guy Ritchie, and Tom Cruise and ex-wife Nicole Kidman took the plunge.

While it’s certainly an exciting event to bring home a baby under any circumstances, bringing home a child orphaned in a foreign country has a special euphoria attached to it because you know that child will be getting many advantages he or she would have otherwise gone without.

While you should certainly enjoy the emotional high, be careful not to let it cloud your common sense. Adopting a child from a foreign country brings with it a number of health issues that you must be prepared to deal with.

Start ensuring good health for your newly adopted child by learning as much as possible about the child's health history before the adoption. Some questions you should ask:

--Is the child's birthdate known? Birth height and weight?

--Has the child had any illnesses, and if so how were they treated?

--Has the child ever taken any medications?

--Does the child have any known allergies?

--Has the child had any immunizations and are the records for those immunizations available?

--What is known about the health history of the parents? Are there any diseases that were common in the parent's families?

Not only are there physical health issues to be concerned about, but emotional health issues as well.

Dr. Jane Aronson is well versed in the health issues surrounding adoption. Through her New York City-based International Pediatric Health Services, she has spent the last 15 years of her life working with families who adopt internationally.

There were two factors that served as catalysts for Dr Aronson’s avocation. First, her pediatric training included a specialty in infectious diseases. As she puts it, "I always had a real hunger for international health issues."

Couple that with the fact that Dr Aronson began practicing in the 80s and 90s during the first great wave of international adoption, and it is easy to see how she has become so prominent in the field of international adoption health issues.

When questioned as to what issues parents should be aware of in the health of their foreign born child, Dr. Aronson said that growth and development should be the primary focus. She pointed out that while physical health issues are important, many of the likely conditions, such as malnutrition or scabies, end up being short-lived. With proper treatment, these conditions usually clear up within six months, she explained.

However, it’s the developmental issues that have long-term effects on the lives of these children.

She explained that, "Children who are adopted from foreign institutions have one month developmental delay for every three months they are in the institution. Younger children have less effects because they have been in the institution less time." A part of this developmental delay also includes poor growth. However, the biggest problem these children face is lack of expressive language. This is not a case of not being able to speak English, but rather being unable to express themselves in their native language. This leads to poor self-esteem and behavioral problems.

The second developmental problem an adoptive family needs to recognize is attachment issues. Children living in institutions never learn the social connections and intimacies of family life that are second nature to a biological child. They have to learn how to make eye contact and become engaged within the family unit.

The third issue is the lack of self-regulatory mechanisms. These children have never had anyone listen to their needs. They have also never learned how to manage their needs and wants. What they have learned is to take care of themselves. Part of the process of orienting a child who has grown up in an institution to family life is to make them understand that it’s all right to ask for help.

If you are contemplating a foreign adoption, Dr. Aronson recommends that you set up a pre-adoption consultation with an international adoption expert so that you know what to expect and what to be prepared for. You can often have this initial consultation by phone or email.

Once you have adopted your child, the international adoption expert can serve as an advocate for you and your child and make the early interventions and referrals necessary for the child’s development.

For more information about where to contact an international adoption expert, log on to Health contributor Maria Esposito contributed to this report.

Click here to check out Dr. Manny's book The Check List (Harper Collins, 2007).

Dr. Manny Alvarez is the managing editor of health news at, and is a regular medical contributor on the FOX News Channel. He is chairman of the Department of Obstetrics and Gynecology and Reproductive Science at Hackensack University Medical Center in New Jersey. Additionally, Alvarez is Adjunct Professor of Obstetrics and Gynecology at New York University School of Medicine in New York City.