Kids’ health and intercountry adoption


Siobhan Rowe
Focus on Adoption magazine

This may be the year you travel abroad to bring a child home. Make your journey easier with this guide.

Before You Travel

  • Know the country you would like to adopt a child from and read up on your child's potential medical issues.
  • Before travelling, get your vaccinations up-to-date by visiting your local travel clinic (if you don’t know your local travel clinic, your local health unit or the blue pages in the phone book should have a list).
  • Make an appointment with your doctor to alert them that you will be bringing a child home and some of the medical issues the child may have.
  • Buy plenty of medical supplies to take with you.
  • If you intend to take children on the trip who are not vaccinated, either have them vaccinated or don’t bring them along: at the very least, it is high riskat the worst, potentially deadly. If you travel with children, bring copies of their health records; you can usually get them from your doctor or local health unit.
  • Child-parent attachment can be an issue for children arriving home from an institution. Read up on facilitating attachment and ask AFABC for details of attachment specialists in your area before you go.

Supply list

Please consult your doctor for advice on these medications.

  • Syringes
  • Ear or underarm thermometer for infants/toddlers; oral thermometer for older children
  • Dosage spoon
  • Tylenol, infant suspension
  • Children’s Ibuprofen or Motrin
  • Polyvisol with Iron (multivitamin)
  • Nix (for lice)
  • Nix Lotion (for scabies)
  • Hydrocortisone Cream 1% (for Eczema and contact dermatitis.)
  • Benadryl (for itching due to hives or rashes)
  • Mycostatin or Nizoral cream (for yeast infection/diaper rash)
  • Bactroban - Fucidin (for impetigo - a bacterial rash
  • Erythromycin Opthalmic Ointment. For pink eye (conjunctivitis)
  • Orabase, for canker sores
  • Pedialyte for diarrhea
  • Epi-Pen for anyone with a known allergy to nuts, bee stings, shellfish or medications

While you're abroad

  • When you are in the country, be careful where you eat and drink. Avoid ice cubes as freezing doesn’t kill all bacteria/larvae. Bring plenty of hand sanitizer with you and use it often.
  • When you meet your child, look out for open sores, rashes or signs of infection. Check between his or her fingers and toes for signs of larval infestations—scabies is common in children adopted from orphanages. Watch out for skin discolouration, which may indicate jaundice (yellowing of eyes/skin) or a blood disorder (excessive bruising/petechiae).
  • Get as much information about your child’s health from the orphanage doctor. However, don’t assume that the records are accurate.

Now you're home

  • Within the first couple of weeks of being home, take your child to your family doctor. Ask him or her to do blood tests, such as an ELISA titre which screens for signs of several past or present diseases/infections. It doesn’t screen for everything, so consult with your doctor about other tests that may need to be done.
  • Visit the health unit nearest you. They are a great source of information; they can give shots, advise on developmental milestones, and refer you to the Infant Development/Child Development Center, speech/hearing therapists, occupational therapists, and physiotherapists. 

Potential health issues

Please don’t be alarmed by this list. It’s only a list of possibilities you need to be aware of.

Prescription for waiting parents

Wise up. If you are planning to adopt internationally, learn more about medical issues, attachment concerns, and issues of race, culture, and heritage. Check our Education section for upcoming adoption education sessions.

Read up. AFABC has an excellent selection of articles on our website. Visit our articles database to browse our huge selection.
Rest up. Once you bring a child home, you will be extremely busy. If you are a first-time parent, take some time to relax, read in bed, go out for dinner, watch movies, and see lots of friends.
Meet up. Connect with our Family Support team in your area. They can put you in touch with other families who have or are planning to adopt internationally.
  • Prematurity
  • Low birth weight
  • Prenatal exposure to drugs, alcohol, or sexually transmitted infections
  • Congenital birth defects: cleft lip and palate, heart defects, scoliosis (curvature of the spine), strabismus ("crossed" eyes).
  • Genetic or metabolic conditions: Down syndrome, hemophilia, sickle cell anemia, thalassemia (major or minor) blood disorder, hypothyroidism, diabetes.
  • HIV/AIDS, hepatitis B or C
  • Birth injuries are often related to insufficient or lack of oxygen at birth (cerebral palsy), seizure disorder.
  • Substance withdrawal (extreme irritability, tremors, excessive crying)
  • Infections: viruses, bacteria, parasites, infestations (scabies/lice)
  • Growth problems: malnutrition and anemia,
  • Emotional behaviours: detached or anxious, sleep disorders
  • Foods/environmental: Allergies
  • Failure to thrive

Pre- and post-adoption medical testing

  • 50% of internationally adopted children come home with medical conditions--mostly infections.

    Screening leads to timely treatment and prevention of disease transmission. The BC Centre for Disease Control has issued guidelines for health professionals on disease screening that should be done. They cover the most common causes of infection amongst internationally adopted children. Investigations done abroad may have to be repeated, and additional investigations may be necessary depending on clinical presentation and country of origin.

    Pre- and post-adoption medical testing can reveal a great deal of hidden information about a child’s health. Parents should be aware that (like all biological children) some disabilities or illnesses do not become apparent until a child is a toddler or older.
  • While we can make some generalizations about particular countries—drinking rates during pregnancy are high in Russia—one can not make assumptions about a child's health based on country of origin.
  • What might be true about a country at one time may be quite different a few years later. Korean adoption has been popular partly because of Korean women's very low drinking rates. However, recent research suggests that drinking rates are now increasing amongst younger Korean women.
  • All medical information should be taken seriously, but it is all suspect. For instance, in Russia, medical terminology can be quite different from that used in Canada, and some terms Russian doctors use can sound alarming but are not a cause for concern.
  • There have been situations where a child is described as being in good health in their medical records, yet that is not the case. The opposite can happen too. There have been cases where a child has been described as having a disability that he or she does not have.
  • As well as birth family history, a preadoption medical review will also consider any medical information available: prematurity, the child’s growth rate (height, weight, head size) and whether a child has reached key developmental milestones. Head growth is very predictive of some problems; it should be requested if head size is not provided.
  • Once a child comes home to Canada, a post-adoption medical assessment is just as important. Considering the child's country of origin, it would include a medical and developmental assessment, vision and hearing, blood and urine testing, testing for certain viruses, parasites and skin problems, and an immunization check.
  • There is often a vast improvement in the health of many internationally adopted children once they come home.

Thanks to Heidi Beckerleg for her contributions to this article.