Preparing to Adopt a Child

Adopting a child is a rewarding experience for many families. Here are some things to know about the health and medical care of an adopted child, before and after the adoption.

What Are the Types of Adoptions?

In an open adoption you meet one or both birth parents. You should be able to get details about the child’s health and family history. 

In a closed adoption, there is no communication between adoptive parents and birth parents. So it might be harder to get complete health information. You can request health records through the agency or attorney who is arranging the adoption.

If you might adopt an older child, you can get a sense of the child's general health by spending time with them before the adoption or by being their foster parent first.

What Should I Know Before Adopting?

Before you adopt, try to gather as much information as possible, including:

• age, height, and medical history of the birth parents
• medical problems that run in the child's family
• the health of any siblings
• birth history, including whether the birth mother:
  • drank alcohol, smoked, or used drugs during pregnancy
  • used any prescription or over-the-counter medicines during pregnancy
  • had any sexually transmitted diseases (STDs) during the pregnancy
  • had prenatal care
  • had any tests done during pregnancy
  • had any problems during pregnancy, labor, or delivery
• growth chart with the child's weight, length, and head circumference
• any medical or behavior problems the child has had, including any hospitalizations or surgeries
• the results of any medical tests
• immunization records
• the child’s development and, if in school, how they’ve done there
• a description of personality, interests, strengths, and relationships with others
• where the child has lived (such as foster care, group home, or orphanage)
• any physical, sexual, or emotional abuse or neglect of the child

If you adopt a child who was in foster care, the agency may be able to tell you where the child got health care so you can either use the same providers or get the records sent to the doctor you choose. This can help your child avoid unnecessary tests and immunizations.

With international adoptions, you're likely to get pictures of the child, but reliable, complete health and family information may not be available. If possible, consider making a trip to meet the child before adopting. You can find out more about the adoption process in different countries from the U.S. Department of State.

Medical Visits Before the Adoption

To help prepare for the adoption, you may want to meet with a doctor to review the child’s available medical and social history. The doctor can interpret the child's medical record and help you understand what to expect, given the child’s medical issues, experiences, and special needs. With this information, you can decide if the child and circumstances are a good fit for you and your family.

You may want to meet with an adoption medicine doctor, especially if you are adopting internationally. An adoption medicine doctor specializes in reviewing adoption records, understanding the medical and emotional needs of adopted children, and connecting families to resources. They have a lot of experience with international medical records and an understanding of the specific health risks from different countries.

if you do adopt internationally, you and all family members and other close contacts (like other caregivers) should be up-to-date on all routine immunizations and hepatitis A and hepatitis B vaccines before the child arrives. Parents traveling to a foreign country to pick up their child also need vaccines for travel as recommended by the CDC. 

Families may also need proof of COVID-19 vaccination or negative testing before travel and on return to the United States.

Adopting a Child With Special Needs

Kids with special health care needs may need extra support for medical, developmental, learning, behavioral, or psychological problems.

If you're thinking about adopting a child with a medical problem or special needs, try to learn as much as you can about the child's condition. Talk to a doctor about the special care they may need and how you can prepare before you make a final decision on adoption. Parents of other children with similar concerns can be a helpful resource before and after the adoption.

Health Care When Your Child Comes Home

Soon after moving into your home, your child should visit your doctor or a doctor who specializes in caring for adopted children. The doctor can confirm and treat any medical, developmental, or behavioral issues. The doctor may order tests or make referrals, as needed.

Because immunization records may be incomplete or inaccurate, some adopted children might need to catch up on their vaccines or get them again. The doctor may check for protective antibodies for some immunizations or past infections.

What Health Problems Can Happen?

Depending on the available medical information, an exam, and where the child is from, the doctor may want to look for:

• anemia
• high blood lead levels
• developmental delays
• hepatitis B and hepatitis C
• HIV
• intestinal parasites
• hearing or vision problems
• metabolic disorders 
• behavior or mental health concerns
• fetal alcohol syndrome or fetal alcohol effects
• rickets
• syphilis
• thyroid problems
• tooth decay
• tuberculosis

It is common for adopted kids to get colds, minor infections, upset stomachs, and diarrhea shortly after arriving in their new homes. These symptoms usually ease as a child adjusts to the new environment. Call the doctor if you have any concerns about your child’s health.

Easing the Transition

If you've decided to adopt, learn as much as you can about your child's daily routine, abilities, and likes and dislikes. Keeping a consistent routine and serving foods that are familiar to the child can help ease the transition. Help your child feel safe and loved in their new home.

Adopted children may have trouble adjusting to their new home, especially children who are older, have lived in multiple homes, or don’t speak your language. Temper tantrums, crying, acting out, being withdrawn, sleeping problems, and feeding problems (like hoarding food and overeating) are common. Some children up for adoption may have been through trauma and will need extra support and comfort. Talk to your care team about strategies to support your child and help with this transition.