Article By Author

Oligophrenia in the Biological mother

Fri, 14 Sep 2007 00:00:00 GMT

The little girl my husband and I may be adopting from Kazakhstan was taken away from her mother because her mother was dx with oligophrenia and was unable to care for her. This scares me because I teach mentally handicapped children and I know many of them have low IQ parents. I also know that environment is a factor. The little girl is almost 2 and she is described as normal development. What are the chances of oligophrenia being hereditary?

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Oligophrenia usually is used to mean mentally deficient. It is an unfortunate term because it is very broad and prone to misuse. Mental retardation has a number of etiologic factors. unfortunately in about 40 percent of cases we never find out the etiology after a thorough investigation. Mental retardation occurs in about 2-3% of the general population but will be higher in less developed nations. The chances of whether there is a genetic cause for mental retardation are therefore very hard to say. It would be reasonable to assume perhaps that if someone suffered some perinatal insult that their retardation would be secondary to that insult.

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A number of single gene disorders can result in mental retardation. Many of these are associated with atypical or dysmorphic physical characteristics. Such conditions include fragile X syndrome, neurofibromatosis, tuberous sclerosis, Noonan's syndrome and Cornelia de Lange's syndrome.

As many as one fourth of persons with mental retardation will have a detectable chromosome abnormality. Children with Down syndrome usually are very recognizable but others such as Klinefelters may not be as noticeable. Other children may have a small deletion that is usually not reported. Some chromosome abnormalities can be inherited but most occur de novo meaning that the pop up in that individual but that they would not pass it on to there offspring.

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As with many things in life there are no simple answers, knowing the increased incidence problems that happen to young children in that part of the world it is likely to say that the mothers problem was probable the result of some perinatal insult or confluence of many factors. No one will be able to give you a very reliable odds estimate.

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On the bright side a knowledgeable examiner should be able to give an idea about this individual child. The statement "normal development" means little to me unless it placed in the proper context. What is the child's head circumference? Was there any delayed milestones? Does the child have imaginative play? When did she enter the institution/how long has she been there? In reality every child put up for adoption has a risk. It is the job of the doctor to give you report of what the risks are. Unfortunately, to do a good job we try to review as much information as we can possibly get.

By James Reilly M.D. of Adoptiondoctors.com & Adoptioneducationclasses.com

* Note: The information and advice provided is intended to be general information, NOT as advice on how to deal with a particular child's situation and or problem. If your child has a specific problem you need to ask your pediatrician about it -- only after a careful history and physical exam can a medical diagnosis and/or treatment plan be made. This website does not constitute a physician patient relationship

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If Arthrogryposis is indicated in adoptive child's medical record?

Fri, 14 Sep 2007 00:00:00 GMT

Arthrogryposis refers to a symptom complex characterized by multiple joint contractures present at birth. This is a description of what we see when the child is born. It is usually caused by decreased fetal movement of whatever etiology.

This is merely a description of a symptom however because there are approximately 150 different syndromes occurring with multiple congenital contractures that are characterized as arthrogryposis.

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The major syndrome (amyoplasia) accounts for approximately 50% of children who have multiple congenital contractures. The cause of this syndrome is unknown but it can affect all of the muscles in the body and can even lead to respiratory failure.

The classic presentation of arthrogryposis is contractures of all four extremities but it is possible to carry this diagnosis and have only contractures of one extremity but this is rare.

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X-rays need to be taken to rule out underlying spinal deformities and hip dysplasia

To understand how difficult and complex the diagnosis can be, imagine that the syndrome can start anywhere from the brain to spinal cord to peripheral nerves to the muscles. Therefore they need a thorough evaluation. . Laboratories might be able to rule out congenital muscular dystrophies and chromosome abnormalities these can be done at birth to help elucidate the etiology.

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Every child with these syndromes should have a complete musculoskeletal evaluation and genetics evaluation.

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Most of the children who have this diagnosis at birth survive to adulthood and need different medical interventions depending on their diagnosis.

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Surgery is needed usually in all of these children and extensive splinting and physical therapy to help improve and get some function.

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These children can be very intelligent (as long as the arthrogryposis is not secondary to a syndrome) so that they can make significant adaptations to their disability and lead productive lives.

By James Reilly M.D. of Adoptiondoctors.com

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"""" Internationally adopted child, carrier of Hepatitis C antibodies""""

Fri, 14 Sep 2007 00:00:00 GMT

Your question is not as easy a question to answer as it may appear. Hepatitis C is a virus which before we used to screen blood for it, was predominantly spread through blood transfusion. Someone who has hepatitis c can spread it sexually and it has been shown to be spread to family members (although this incidence is very low).

However having antibodies does not mean that you have hepatitis C virus in you currently, it could mean that you had it in the past and have already killed it. To know if someone is still potentially infectious you need to do a PCR test to look for the virus itself.

It is also possible that the mom had hepatitis C and merely passed on her antibodies to an infant without passing on the virus itself. PCR tells us if the child could pose a risk and that is the test you need to search out.

I hope this has been helpful.

Written by James Reilly M.D.

Worries about HIV infection in the orphan child

Fri, 14 Sep 2007 00:00:00 GMT

This question is not so simple as it would appear. First we never say whether someone should or should not adopt someone, because children can be adopted with HIV infection to avail the child of the myriad opportunities for treatment that are available in the United States.

HIV is an infection caused by a virus which is known to be transmitted from mother to child. The transmission of the virus can be decreased from approximately 30 percent to eight percent with the perinatal treatment with antiretrovirals.

The HIV antibody test can be positive in an infant just because they are the infant of an infected mother and the antibodies are able to cross the placenta.

If the mother has antibodies then the child could have antibodies. What was the medical condition of the mother? This could effect the way that we interpret these results. This child is reported to be "negative" at birth although at birth tests such as PCR, HIV culture, detection of HIV RNA or detection of p24 antigen are usually done because of what we previously stated.

A child over the age of 6 months we can follow the HIV antibodies because they start to wane. A child is considered negative if two consecutive HIV antibody tests are negative and the child has no other clinical or immunologic abnormalities. This of course assumes that the tests are being done correctly. It is recommended that all children who come to the United States be screened for HIV at least once.

The good news is that in recent studies that children from international adoptions seem not to be initially negative and then become positive. This is something that we always worry about but, our experience with this issue is very positive.

The other part of this question is that we know about the HIV infection but are there any other infections that could have been transmitted to the child by the mother. Hepatitis C,B, and syphilis should be tested. These infections should be checked in all international adoptees but information about the mother could effect the way we investigate a child.

As usual the lack of information puts us at risk because we cannot say anything with a great degree of certainty. Ideally another test could be done and sent to an American reference laboratory for the appropriate testing if this is something that is considered to be vitally important.

By James Reilly of Adoptiondoctors.com and Adoptioneducationclasses.com

For Pre-adoption Medical Evaluations and Post-Adoption General care on Long Island New York, Visit us at our International Adoption Private Medical Clinic.

Preparing for International Travel to pick up adoptive child

Thu, 13 Sep 2007 00:00:00 GMT

Traveling to another country can have its own hazards. Your own health changes all the time and it is a good idea to get a checkup before you go on a long trip where it will be difficult to get medical care.

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It is also important to consult the centers for disease control website www.cdc.gov for information on infections that may be ongoing in your destination country. It will also provide you up to date information on any vaccines you may need and also things you may need to bring with you.

If you do get sick abroad personal physicians worldwide 1-888-657-8114 & international association for assistance to travelers 1-716-754-4883 are resources you can use as well as your adoption agency.

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There are clinics available in most large cities, which specialize in persons traveling abroad, and they can be a valuable resource to you and you physician about what you can expect. Also speaking with the adoption agency and with other people who have made the same trip is useful.

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Preparation for travel with children

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Antibiotics and respiratory infections

In this country, with ready access to quality healthcare it is not advisable to treat overly simple colds and coughs. Being abroad with a child who is malnourished, living in an institution without thorough knowledge of their recent health however it is advisable to bring with you antibiotics for illnesses, which seems to be overly affecting the child.

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Consulting with your child's future pediatrician is the ideal way to handle this situation before giving any antibiotic but because of time delay sometimes this is not possible. Many experts suggest bringing with you an antibiotic such as zithromax in a powdered form with sterile water premeasured by the pharmacist so that all you have to do is mix them together. The dose is 10mg for every kilogram given once a day for three days for most simple infections.

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Bacitracin/Topical Antibiotics

It is useful to bring with you an antibiotic ointment and bandages because having a child means having bumps bruises and cuts. Any decent first aid kit is invaluable.>

Conjunctivitis

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(contemporary pediatrics 1997 Wagner)

If you are confronted with a child whose eyes look like these, an antibiotic drop such as polytrim placed in the affected eye(s) three times a day for seven days usually effects cure.

These drops should be acquired ahead of time and require a prescription.

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Atopic dermatitis

This is a common condition among children who are being internationally adopted it appears and is treated as the pictures/table below. Normally Dove unscented is the soap most recommended by pediatricians for all children, but especially for children with sensitive skin.

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TABLE I

Treating atopic eczema

Keep the skin at a high, even level of humidity

Apply 1% hydrocortisone cream as needed

Apply liberal amounts of a topical moisturizer such as Vaseline many times a day<

Sources: Bigby M: A thorough systematic review of treatments for atopic eczema.

Arch Dermatol 2001;137:1635; Oranje AP, De Waard-Van Der Spek FB:

Atopic dermatitis: Review 2000 to January 2001.

Curr Opin Pediatr 2002;14:410

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Cradle Cap

Cradle cap is a normal finding in infants and is easily treated with nizoral shampoo, which is available over the counter.

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Care should be taken not to get the shampoo into the eyes but otherwise it is fairly safe to use. It appears here in its worse form, normally it is not so terrible but it can get as bad as this.

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Diaper Care

Diaper rash commonly appears as below but it can be erosive with bleeding or with small bumps or pimple, which usually means superinfection with either a fungus or a bacteria. Normally most diaper rashes can be taken care of as outlined in the table below.

(Source Shwayder July 2003 contemporary pediatrics)

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TABLE 2

Preventing and treating diaper rash

Keep the child's bottom clean and dry; change the diaper frequently

Clean the perineum gently when changing the diaper

If the skin is red, use 1% hydrocortisone cream twice a day mixed with lotrimin cream, which is an antifungal foot cream available over the counter. Cover the cream and the diaper area with zinc oxide paste or desitin ointment.

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Scabies

Scabies are caused by a round mite that is 0.4mm long has four legs and is spread by direct contact. It is incredibly itchy with pustules and burrows on the skin. Treatment is with elimite commonly and needs to be prescribed by your pediatrician.

(Source Shwayder July 2003 contemporary pediatrics)

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Allergic reactions

Use of benadryl liquid 12.5mg/5ml(one teaspoon) usually is a safe medicine to use for acute allergic reactions associated with hives.

The dose is approximately 1mg/kg. It is not used in infants, follow the package directions.

Some kids respond to benadryl by becoming extremely active. It should not be used to provide sedation.

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(Schmitt cont peds 2003)

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Lice

Sometimes with lice there can be no signs or symptoms and they are discovered when cleaning the child's hair.

As with scabies this is commonly found in institutionalized children and is treated with an over the counter preparation called nix most commonly/effectively.

Follow the package directions.

(Source Shwayder July 2003 contemporary pediatrics - picture)

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Tylenol/Motrin

Tylenol or Motrin is invaluable when the child has fever or sick and appears off. The dose for Tylenol and Motrin is 10mg/kg; both can be given every 6 hours. It is easier to travel with the children's formulation and if dosed appropriately can be given at any age.

It is a good idea to bring a dosing syringe available at any pharmacy so you can dispense these medicines.

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Nasal congestion

Plain nasal decongestants are usually all that are needed if a child has a stuffy nose and cannot sleep. Plain pedicure nasal decongestant for kids 3 months to one year and plain Sudafed for children are commonly used.

Dosages depend on the formulation and can be obtained from your pediatrician.

Diarrhea

Diarrhea and vomiting can occur at any time in children and it is advisable to be prepared. Pedialyte or powdered electrolyte solutions, which can be reconstituted with boiled water as needed, are usually brought. These are usuallly given if the child is having excessive vomiting or diarrhea. Normally most pediatricians try to feed through bouts of diarrhea in infants with small amounts of formula given more frequently. However if there is decreased tears/urine output or saliva and oral rehydration solution and consultation with a professional is advisable.

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Constipation

The opposite end of the spectrum is constipation and certainly with a change of diet this can be seen. Most constipation is treated effectively by increasing fruit intake especially prunes/prune sauce. Instant relief can nearly be provided through the use of glycerin suppositories although regular use is not advisable it is very helpful in a pinch.

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Feeding

What to feed and bring with you depends on the health background and age of the child you are adopting and it is advisable to consult your pediatrician.

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You may also ask the adoption agency to provide information as to what the child is currently eating and use this as a guideline for what types of foods your child will accept. For example if the child is not eating from a spoon then the time to start will be back in the states.

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The Academy of Pediatrics puts out a book called "Caring for Your Young Infant and Child." It has almost everything that you ever wanted to know and perhaps things you do not want to know about children. If you want a definitive source for childcare, this is it. It goes into great depth about how to feed children and to take care of them.

Written By James Reilly of Adoptiondoctors.com and Adoptioneducationclasses.com

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Disclaimer

The information and advice provided is intended to be general information, NOT as advice on how to deal with a particular child's situation and or problem. If your child has a specific problem you need to ask your pediatrician about it - only after a careful history and physical exam can a medical diagnosis and/or treatment plan be made. This Web site does not constitute a physician-patient relationship.

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Microophthalmia in the adopted child

Thu, 13 Sep 2007 00:00:00 GMT

Microophthalmia

There is an orphan available with a condition called MICROOPHTHALMIA. She is 18mos old and is blind in one eye. Can you tell me more about this condition? Can anything be done to regain her vision? Is this condition linked with a syndrome that may not be showing yet?

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Is a disorder of the development of the eye which is akin to not having

developed an eye at all ? �Midline defects such as this are often associated

with other abnormalities since the development of the eye begins very early

in development. In other words something that effects the development of the

eye seems to effect the development of a lot of other things in the body.

This disorder can be seen as part of fetal alcohol syndrome but in my

review of the literature it seems it may be most commonly associated with

some genetic/prenatal insult.

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Without other information it is impossible to say what is the prognosis

for this unfortunate child because this may depend on other factors that may

only be known with time. It may or may not be associated with other

abnormalities, some of which are severe.

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Her capacity for normal vision also depends on what exactly is the cause

of her blindness this can best be told to you after an exam by an

ophthalmologist.

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Thank you for your questions, sorry I could not be more informative but

unfortunately without more information we cannot give you more than a

general view.

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Written By James Reilly of Adoptiondoctors.com and Adoptioneducationclasses.com

For Pre-adoption Medical Evaluations and Post-Adoption General care on Long Island New York, Visit us at our International Adoption Private Medical Practice.

This website does not constitute a physician patient relationship

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Reader's Question of Tethered Cord

Thu, 13 Sep 2007 00:00:00 GMT

During fetal development the spinal cord occupies the entire length of the vertebral column, this cannot persist because when the child or the adult bends this may cause a kink in the blood supply though the spinal cord.

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Surgical transaction to the thickened cord tends to halt the progression of neurological signs and prevents the development of dysfunction in asymptomatic patients.

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Surgery prognosis is a very difficult area to analyze. In a recent review of three different neurosurgeons with commonly done neurosurgical procedures the outcomes varied greatly. It did seem however that there was a very low rate of poor neurological outcome after the first surgery for tethered cord. The best way to evaluate the prognosis of any surgery is to look at the history of your surgeon what are his/her outcomes like. Is the surgery more complicated than other patients( many times tethered cord may be associated with other abnormalities which can effect the outcome of the surgery).

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If the patient needs a second or third procedure the risk for an adverse outcome is improved. If there is solely a tethered cord release it seems however that 97% of the kids are ok 25 years out from surgery.

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As always however 97% is fine unless you are one of the three percent. What I try to get my patients to focus on is what is happening now and how can we maximize what we are doing now instead of looking ahead to possibilities which in the future may not apply to us.

I hope this has been helpful

Written By James Reilly of Adoptiondoctors.com and Adoptioneducationclasses.com

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Reader's Question on Streptodermia

Thu, 13 Sep 2007 00:00:00 GMT

I have a video and medical on a 10 year old little girl from Russia. She appears very normal and healthy. Her medical history says she has had streptodermia and acute glomerulonephritis (hematuria type). Chronic glomerulonephritis in remission. What is this medical problem?

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Glomerulonephritis is both a generic term for several diseases and a histopathologic term signifying inflammation of the glomerular capillaries in the kidney. Outbreaks are known where "nephritis" strains of group A strep germs are circulating in the blood stream, it is usually is sporadic.

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Since there are many different forms of glomerulonephritis there are many different ways it can present. Post streptococcal glomerulonephritis usually presents after an illness with the strep germ either through strep throat or classically from a skin infection such as impetigo. It is most common in children aged 5-12 yr and uncommon before the age of 3 yr. The typical patient develops an acute nephritic syndrome 1-2 wk after an antecedent streptococcal pharyngitis or 3-6 wk after a streptococcal pyoderma, or skin infection.

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The patient usually can present with coca cola colored urine or it can be found incidentally on examination of the urine. There can be increases in blood pressure if the kidneys are significantly damaged along with edema (swelling of the extremities).

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Urinalysis demonstrates red blood cells, RBC casts, proteinuria, and polymorphonuclear leukocytes. Anemia may be present from low-grade hemolysis and retention of fluid. The serum C3 level is usually decreased in the acute phase and returns to normal 6-8 wk after onset.

A positive throat culture report may support the diagnosis or may simply represent the carrier state. The best single antibody titer to document coetaneous streptococcal infection is the deoxyribonuclease (DNase) B antigen. An ASLO may be done but it notoriously does not rise after skin infections with strep.

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The diagnosis of poststreptococcal glomerulonephritis is quite likely in a child presenting with acute nephritic picture, evidence of recent streptococcal infection, and a low C3 level. It is important to consider other diagnoses however.

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Treatment of the infection which caused the post streptococcal glomerulonephritis is done first, and then treatment is supportive. Management is directed at treating the acute effects of renal insufficiency and hypertension .A 10-day course of systemic antibiotic therapy with penicillin is recommended. However it does not affect the natural history of glomerulonephritis. The acute phase generally resolves within 6-8 wk. Although urinary protein excretion and hypertension usually normalize by 4-6 wk after onset, persistent microscopic hematuria may persist for 1-2 yr after the initial presentation.

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Complete recovery occurs in more than 95% of children with acute poststreptococcal glomerulonephritis.

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Mortality in the acute stage can be avoided by appropriate management of acute renal failure, cardiac failure, and hypertension.

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Infrequently, the acute phase may be severe. However, the diagnosis of acute poststreptococcal glomerulonephritis must be questioned in patients with chronic renal dysfunction because other diagnoses such as membranoproliferative glomerulonephritis may be present. Recurrences are extremely rare.

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By James Reilly M.D. of www.adoptiondoctor.com

This website does not constitute a physician patient relationship

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Sponge kidney on medical reports

Thu, 13 Sep 2007 00:00:00 GMT

Most patients discovered incidentally to have medullary sponge kidney can

be advised that the disorder is benign and that they can anticipate no

serious morbity or mortality from the disorder.

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On the other hand, kidney stone formation can occur in some patients and

can be a difficult problem. Its incidence is approximately 1 in 5000 in the

general population.

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The only associated abnormality that occurs is growth of one side of the

body but this would be fairly evident on physical exam.

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Written By James Reilly of Adoptiondoctors.com and Adoptioneducationclasses.com

For Pre-adoption Medical Evaluations and Post-Adoption General care on Long Island New York, Visit us at our International Adoption Private Medical Clinic.

This website does not constitute a physician patient relationship

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Medical requirements for Adopted child with Tetrology of Fallot

Tue, 31 Jul 2007 00:00:00 GMT

Tetralogy of Fallot is an anatomic misalignment of the heart. The abnormality is quite complex and left untreated these children will do poorly. This condition requires open heart surgery for correction. Surgical mortality is now quite low in most centers in the United States which means that all things being equal most kids do well. At Children's Hospital of Philadelphia it is recommended to have surgery in infancy 3-6 mo for optimal outcome before the children become
cyanotic (blue).

Residual homodynamic abnormalities are commonly seen afterward as well as abnormalities in cardiac function. These children require follow up also by the cardiologist since they are at risk for arrhythmias (irregular heartbeats). They usually lead fairly normal lives but their hearts are never the same as a normal heart.

How well the children do is very dependent on factors which vary from child to child. It is therefore impossible to say with great assurity what someone's life will be like because a lot of times how someone does with a surgery depends on their personality and support.

I hope this has been helpful,

Dr James Reilly MD of www.adoptiondoctors.com

* Note: The information and advice provided is intended to be general information, NOT as advice on how to deal with a particular child's situation and or problem. If your child has a specific problem you need to ask your pediatrician about it -- only after a careful history and physical exam can a medical diagnosis and/or treatment plan be made.
This website does not constitute a physician patient relationship.

Bedwetting in the Internationally Adopted Child.

Tue, 31 Jul 2007 00:00:00 GMT

Bedwetting in the Internationally Adopted Child.Bedwetting or Enuresis:

Enuresis is defined by involuntary urination after the age of expected bladder control it is generally reserved for children six years of age or older.

Epidemiology-20% of children at the age of 5 years wet the bed at night. 10% wet the bed at seven years, 5% at the age of ten years.

Nocturnal enuresis is more common in males than females. 70% of children with enuresis have a parent who has enuresis.

Enuresis again is not abnormal in a child who is four years old so expecting them to be dry through the night is unreasonable. If they are dry thru the night then you are merely lucky.

It is important to take a good history. If the child had been trained thru the night, has any abnormalities of the spine or there is any abnormalities in the stream then they need a further work-up.

Diagnosis-
Children who have this problem need to undergo a work up. Urinary tract infections, sugar in the urine, abnormalities of kidney/bladder function, and other more obscure reasons. Usually the urine is examined and perhaps cultured.

Therapy- education is important. The parents need to remain positive and to refrain from aggressive attempts at therapy until the child is around 6yrs. Alarm systems are the most effective of all interventions. They usually take time to work. There is drug therapy but all of the therapies have there side effects and are usually not used first line especially in younger children.

Prognosis- is excellent with 15% resolution rate every year without any treatment.

It is difficult to say what is normal when you are presented all of a sudden with a four year old child especially since sometimes friends or family may not remember what it is like to have children. This is a common situation for persons who adopt a child. The American Academy of Pediatrics puts out a definitive source on raising children. It talks about all the different things that parents usually will/may need to know such as what is the proper water temperature in your home? Does my child need vitamins? What car seats have been recalled because they are unsafe? Etc. "It is called caring for your young baby and child". It covers birth to age 5, I do not get any royalties and it does not pay for the pediatrician retirement home but it is an excellent source of information put out by pediatricians.

Written by James Reilly M.D. of www.adoptiondoctors.com

* Note: The information and advice provided is intended to be general information, NOT as advice on how to deal with a particular child's situation and or problem. If your child has a specific problem you need to ask your pediatrician about it -- only after a careful history and physical examination can a medical diagnosis and accurate treatment plan can be made.

Adopting a child whose birthmom used Marijuanna during pregnancy

Tue, 31 Jul 2007 00:00:00 GMT

In general doctors are not too crazy about the idea of pregnant ladies taking any drug when they are pregnant either legal or illegal unless it has been rigorously studied to have no harm to the developing child. The main active ingredient of marijuana, tetrahydrocannabinol, can cross the placenta and thus may affect the fetus. Marijuana is the most widely used illegal drug in the USA among women of reproductive age despite this fact there is a relative lack of literature dealing with this problem.�

How Marijuana works in the brain is thru the receptors in our brain which respond to our natural chemicals. When it binds to our brain it gives the "high feeling" the user is looking for. The worry is that when it binds in a developing brain can this change the way the brain develops requiring more natural chemicals or making the brain resistant to these chemicals.� �

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There are some studies that seem to show that marijuana can effect the development of the nervous system in a baby as evidenced by the increased nervousness/tremulousness and irritability that is seen after a child is born whose mother abused marijuana.

When these children enter school they are noted to have more behavioral problems and seem to have problems paying attention in school. The also appear to have more problems with memory at four years of age when compared to other children. They also have deficits in problem solving skills. Exposed children do not appear to have a decrease in IQ.�

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Later in life the outcomes are less clear what exactly happens. There seem to be no good data on what kind of "citizens" these children become.�

The problem with marijuana is that it is usually not abused in isolation and that it is usually found in someone who at the same time is smoking cigarettes and perhaps drinking alcohol. These co-drug exposures make it difficult for researchers to say definitely what causes damage in a developing child's brain

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Written by James Reilly of Adoptiondoctors.com

Article By Author

Oligophrenia in the Biological mother

If Arthrogryposis is indicated in adoptive child's medical record?

"""" Internationally adopted child, carrier of Hepatitis C antibodies""""

Worries about HIV infection in the orphan child

Preparing for International Travel to pick up adoptive child

Microophthalmia in the adopted child

Reader's Question of Tethered Cord

Reader's Question on Streptodermia

Sponge kidney on medical reports

Medical requirements for Adopted child with Tetrology of Fallot

How well the children do is very dependent on factors which vary from child to child. It is therefore impossible to say with great assurity what someone's life will be like because a lot of times how someone does with a surgery depends on their personality and support. I hope this has been helpful,

Bedwetting in the Internationally Adopted Child.

Bedwetting in the Internationally Adopted Child.Bedwetting or Enuresis:

Enuresis is defined by involuntary urination after the age of expected bladder control it is generally reserved for children six years of age or older.

Epidemiology-20% of children at the age of 5 years wet the bed at night. 10% wet the bed at seven years, 5% at the age of ten years.

Nocturnal enuresis is more common in males than females. 70% of children with enuresis have a parent who has enuresis.

Written by James Reilly M.D. of www.adoptiondoctors.com

Adopting a child whose birthmom used Marijuanna during pregnancy