International Adoption

When the child arrives in the United States, a complete medical evaluation is performed usually within a few days of arrival.  The first visit to a pediatrician after adopting a child from outside the U.S. should be a comprehensive medical encounter which includes:

• Review of medical data updated since travel abroad

• Physical examination and interview to clarify immediate medical issues such as feeding problems and to decrease parental anxiety

• Well-child issues are reviewed with parents and standard medical/developmental issues are discussed as they apply to the particular age of the child

• Blood is obtained during the office visit and laboratory evaluation

Consider Metabolic, Genetic or newborn screen

Syphilis serology (VDRL or RPR)

Hepatitis B, C serology (Hepatitis Screen)

HIV serology

ESR, Quant CRP

Liver panel

Chem 7, calcium, phosorus, magnesium and consider Vitamin D / Parathyroid hormone level (intact)

Serum lead and consider Heavy Metal screen

Complete blood count, retic

Urinalysis

Stools for Ova & Parasites, enteric pathgens, WBCs, occult blood, eosinophils

Thyroid panel

Consider Glucose-6-phosphate dehydrogenare and Hemoglobin electrophoresis

PPD (Mantoux test for tuberculosis)

Bone age x-rays (as needed)

Neurologic and ophthalmologic specialty exams based on physical examination

Early intervention referral

Hearing and vision screening