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Anemia in Adopted Children

Anemia is widespread in children adopted from abroad. Malnutrition is the major cause of iron deficiency anemia. It has been documented in the medical literature of specific countries, like China. [Chen et al. 1992b] A complete blood count (CBC) will uncover anemia. Forty children (31%) out of a population of 129 who were screened in an adoption clinic in Boston were anemic. [Miller et al. 1995b] We know that iron deficiency anemia can interfere with normal growth and be a cause of developmental delay and learning problems. With proper nutrition and iron supplementation, anemia can resolve and medical complications can be minimized.

There are also genetic anemias that are found in children from specific countries like Vietnam, Cambodia, Thailand, and China. When there were great waves of immigration of Southeast Asian individuals during and after the war in Vietnam, physicians gained experience in the epidemiology, diagnosis, and treatment of anemias indigenous to this area of the world. This has helped pediatricians enormously in their understanding of anemia in children adopted from this part of the world. [Glader & Look 1996] Having a genetic trait for an anemia is generally not harmful to the individual, but in combination with the same trait as might occur during reproduction, this can lead to a life threatening disease in the newborn infant. A CBC and a hemoglobin electrophoresis test will reveal underlying hemoglobinopathies (anemias due to abnormal hemoglobin proteins). Another unusual abnormality of red blood cells is a deficiency of an enzyme, glucose-6-phosphate dehydrogenase; this genetic enzyme deficiency can be found in southern Chinese, Southeast Asians, Filippinos, Greeks, Italians, Sephardic Jews, and African Americans and can cause anemia when there are particular exposures to certain medications and infections. [Segel 1996]

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