Health and Growth of Internationally Adopted Children

Because there are many families awaiting court next week to go get their children in Rwanda I thought I would share some info on determining your child's growth and development. The children residing at Home of Hope Orphanage in Kigali, Rwanda have all been abandoned thus their age is guessed at when they are brought to the orphanage. The younger the child the easier this of course is but there can still be mistakes in paperwork that may give you a birthdate that is off. Since you only receive the results of recent medical testing and no info regarding prior health history, I asked specifically for any records documenting our son's growth while at Home of Hope. They were able to give me a record in which his height and weight had been documented every month since he had arrived at the orphanage. His first record was in November 2007 and he weighed 14 pounds at intake. Based on his facial picture and weight at the time it was predicted that he was around 9 months of age. I think that is probably the minimun that he could have been given his facial features and the report that he was crawling when found. So I was surprised to see that his birthdate given on the Rwanda court records which resulted in his Rwandan birth certificate have him being born in November 2007, the month that he was brought to the orphanage. Not a huge deal as far as when he will start school, being a boy it will probably be better for him to start later, but it makes a huge difference when I look up his growth on any of the various height and weight growth charts. This was a aha moment for me. At age 33 months he only hits the 25th percentile for height and he is not even on the chart for weight, not even the lowest 5th percentile. So how could that be? When I translated his growth progress on the chart to US measurements he has not made steady growth over the last two years. He would sometimes gain weight, sometimes not at all, and sometimes loose from month to month. A malnourished diet could definitely be a explanation but more likely the up and down growth may be related to illness and parasites. So we are requesting a full battery of tests to invetigate every possible parasite that a child from Africa may have (learned that you need to demand this to your doctor after dealing with unidentified medical needs with our daughter). Why does this all matter so much to me? Well I think it is important to be able to assess how a kido is doing developmentally when they have spent a extended amount of time in a orphanage. He will most likely need some help to catch up to his peers. What I have observed in my daughter is that she regressed a bit after coming home and really needed to re-experience some of those early developmental periods with us as her parents. Once she was settled in with us she then made very quick physical and developmental growth the first year home but now some specific areas seemed to have stalled and we are needing some more work to do. I don't want to worry adoptive parents to much. It is very important to be optimistic and to know that children are amazingly resilient but you also have to balance out reality so that you can give them the help that they need. Sometimes that takes some extra investigation.