Primary Care Pediatrics
Primary Care PediatricsPrimary Care Pediatrics
Current Travel and Initial Medical Evaluation Information February 2000Developmental evaluation The focus of the first examination is developmental. Children adopted from abroad who have lived in foster care or orphanages may be developmentally delayed, but with time for adaptation, most of these children catch up quickly. Often consistent nutrition and a loving home can facilitate a child's development. After a 3-6 month transition period which includes several developmental screening examinations, a developmental assessment is more representative of the child's level. Referrals for early intervention are made after a sufficient time for adaptation is allowed.Immunizations Immunizations are offered and encouraged since the past medical history of adopted children is not easily verified. Parents are advised that repeating immunizations is generally safe. Most countries outside the U.S. do not administer Haemophilus influenzae b vaccine which until recently was the number one cause of meningitis in children. Hepatitis B vaccine is also only administered universally in a few countries outside the U.S. and hepatitis B is a viral infection which is associated with long term disabilities like chronic liver disease and liver cancer.Consultation letters A consultation letter is prepared and forwarded to the child's pediatrician summarizing the history and physical examination. The letter includes all of the laboratory results and a summary of management strategies prescribed for the more common medical problems associated with international adoption such as scabies, lice, anemia, parasitic infection, rickets, TB infection, failure to thrive, and developmental delay. Feeding is a major focus of the initial medical evaluation and recommendations are reviewed in the letter. Letters are also prepared to document any medical diagnoses in the process of substantiating parental leave from jobs as well as for health insurance companies requiring documentation for reimbursement. Referrals for pediatric subspecialists are also recommended as needed.Follow-up medical care Follow-up medical care can be provided by the International Adoption Medical Consultation services at Winthrop Pediatric Specialty Center.Medical Issues in Other Countries
General Medical Issues
Immunizations for Families Going Abroad for an Inter-country Adoption
Overview of Medical Issues in International Adoptions
Laboratory Screening Tests for International Adoptions
Alcohol Related Birth Defects and International Adoption
Anemia
Giardiasis
Hepatitis B and C
Hepatitis B Vaccination Imperative for Families Adopting Abroad
Iodine Deficiency
Scabies
Tuberculosis and International Adoption
International Adoptions Pose Extra TB Problems
China
An Update on Health Issues in Children Adopted from China
Age in Chinese Children
Hardy Survivors from China Transition from Orphan to Child
Lead Exposure in Chinese Children
Lead Intoxication in Children Adopted from China
Russia
Prevalence of Fetal Alcohol Syndrome and Fetal Alcohol Effect in Pre-adoptive Evaluations of Children in Russian Orphanages
Guidelines in Understanding and Interpreting Medical and Video Reviews from Russia
Syphilis in Eastern European Medical Reports
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