Questions on the medical health of children adopted from Vietnam?

Many children adopted from Vietnam from institutional care environments like many other countries have mild caloric deprivation, mild to moderate developmental delays and growth delays. Fortunately, experience shows that, given family love, nourishment, and medical care, these children rapidly develop into natural little kids.
Like many other countries, especially those in parts developing world, the disease encountered in children are generally secondary to overcrowded conditions, neglect, and lack of medical care. Infectious diseases are the most prevalent ailments affecting children that lived in the orphanages of Vietnam. Orphans children and even those in foster homes, are exposed to more than their share of colds, flu’s, and stomach bugs. A similar situation that happens in the U.S.A, but the contrast is that when a baby becomes ill, he is immediately removed from the situation in order to reduce the spread of infectious disease to the other children of the community. Unfortunately, in orphanages this does not happen.

Some of the more common infections found in Vietnam orphans are frequent ear infection and respiratory infection like bronchitis and sinusitis. Often times there are out breaks of parasitic infections such a scabies or head lice. This occurs because of close contact between the children and from poor hygiene. The practice of shaving the head of a child is performed in order to prevent the spread of head lice, which is an infection affecting the scalp and hair.

Parasitic diseases are much more widespread than many people realize, especially in impoverished peoples in remote countries of the third world. Pinworm, Ascariasis, Hookworm Disease and Giardia are some of the more common parasitic infections in orphan children. Giardia appears to be one of the more commonly occurring parasitic infections of children adopted from Vietnam. Symptoms include diarrhea, abdominal cramps, bloating, flatulence, malaise, nausea, and loss of appetite. Stools can be watery and profuse and/or foul-smelling. Periods of diarrhea may alternate with constipation and normal stools. Children may experience weight lose or even “failure to thrive” with long term infection.

Fortunately, HIV infection while it still exists worldwide, we generally do not worry as much as we did historically about this infection because of international awareness and universal precautions used to prevent the spread of the disease. In most countries, reliable HIV testing is performed at birth and made available to prospective parents prior to accepting their referral.

Malnutrition and growth delays secondary to neglect are also common place in children that live in orphanages in Vietnam. Adoptive parents are generally concerned when their child’s growth parameters fall below the standardized CDC growth charts that we use in the U.S.A for healthy routine children. Parents must understand that orphan children may not always be healthy, they are malnourished, neglected and may be suffering from chronic medical ailments. Growth delays are expected in such children. I have read some of the research in the International Adoption Medical community and it states that for every three to four months that a child lives in a orphanage environment, there is an expected one month delay in the growth parameters.

It always amazes me when I see a child that I had initially evaluated on the medical records and find growth delay. Upon placement in a nurturing adoptive home, the children’s sizes change dramatically, due to the advent of “catch-up” growth. The usual pattern that I observe on the growth chart is almost a vertical line improvement on the growth chart. Parents and physicians the same must realize that when this phenomenon does not occur, one must look for underlying medical conditions hindering the growth.

Developmental delays in speech, gross and fine motor tones are also one of the more prevalent conditions found in orphan children. Delays in developmental health are common in many of the orphan children, the degree and severity of problems is directly proportional to the length of time of institutional care living. Fortunately, like with the growth parameters, these delays also respond well to a loving and nurturing home environment.

Your child’s medical circumstances, health history, early care and nutrition, genetic heritage, and even parental involvement and knowledge of child health can impact their weight, growth and developmental well being. If your child does not make significant progress in growth over time, then you may need to seek the guidance of a pediatrician to look into possible contributing factors (e.g., Parasites or allergies and milk/food intolerance and nutritional related issues such as malnutrition.

By George Rogu M.D.CPE