Monday, July 18, 2011

Raising a Healthy Adopted Child: "At the Doctor"

One of the first things on the agenda after getting home from China was to have Mae looked at by our pediatrician. Many families choose to go through an International Adoption Clinic for their child's evaluation. These clinics specialize in these children and often will do extensive bloodwork and other tests to determine the child's health and immunization status.

Because Mae was clearly thriving, we could tell that she didn't have anything worrisome, so we went with our regular pediatrician. After a thorough exam, we all agreed that she was exceptionally healthy and right on target developmentally. We agreed to do a TB test (she came back negative) and to re-start her immunizations.

Often, our doctor explained, immunizations given in orphanages may be expired or improperly stored. A study published from the University of Minnesota adoption clinic in 1998 by Hostetter et al.7 showed that only 35% of kids with records of vaccines administered, from Eastern Europe, Russia, and China had antibodies to diphtheria and tetanus, but 65% of those kids did not! Older children can have a modified vaccine schedule based on individual titer assessments.

We chose not to have titers done since it meant bloodwork, a very big trauma for my oldest son. With his experience in mind, we chose to re-immunize. We did choose to take it slow, just two vaccines every two months until she caught up.

Another area of contention for some children is the growth chart. There is a Chinese growth chart (that Mae was off the chart on, so we didn't need to use it) and if the child seems abnormally petite, it is advisable to check that chart before panicking. Here is a link to recent Chinese growth charts, courtesy of FWCC.

If the child is still on formula, this can be the trickiest of all to adjust to a Westernized standard. Formula at many orphanages in China is simply sweetened powdered milk added to boiling water. Between the intense sweetness of the powder and the severe temperature of the water, it takes a long time to wean the child to a reputable brand of formula, drunk luke-warm.

Mae refused her bottle for a long time in China because I couldn't bear to boil the water. She didn't have any burn lesions on her throat that I could see, but I just couldn't imagine sucking down anything that hot. Add to that the X cut on the nipple of the bottle and she couldn't even control how fast it was coming.

Chinese babies' bottle nipples are often cut with an X to make the formula stream out faster. Many believe that is why most Chinese children have a distinct 'rounding' to their words - they never had to suck and develop those mouth muscles! More on that when we discuss Speech Therapy.

Needless to say, we gradually adjusted her to Enfamil at a warm temperature but it took a long time. Luckily, at 10 months old she could eat steamed egg, congee and any soft fruits and vegetables, so she wasn't as reliant on formula as younger babies can be.

All in all, the doctor visit and its ensuing "things to fix" can be overwhelming. Luckily, I had other adoptive parent friends from our travel group and we could talk about all of these things together. Nowadays, with the internet being what it is, it is even easier to connect with other families whose situation mirrors your own.

How was your first doctor visit with your newly-home child? What areas did you feel you had to work on? Was your doctor familiar with adopted children or did you need to see a specialist? How is she doing now?

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